Rethinking Treatment

Abstract:Albuquerque, New Mexico's Presbyterian Hospital used Six Sigma to update its insulin-delivery operations. The goal was to both increase the number of patients who met the glycemic goal range and reduce the average length of stay to half a day or less. The improvement team chose a Six Sigma approach to get a clear monetary return, emphasis on strong leadership and management support, and decision making based on verifiable data. The team used a variety of quality tools at every stage of the define, measure, analyze, improve and control (DMAIC) sequence to implement the change. A voice of the customer (VOC) review identified a number of process issues, which were found to derive from five root causes. The team implemented solutions to address all of these root causes, resulting in a 14 percent increase in the number of patients meeting the glycemic goal range and an average length of stay of less than a third of a …

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--Maurizio Bray, 08-29-2012


On the next planned round of planned improvements--namely, provider participation/adherence--if, after the nursing staff improvements, there is still a strong correlation between option two usage rate (within two days of hospital stay) and percentage managed to optimal glycemic range, taking a current state sample of patient performance by provider in these two measure areas and comparing it to post provider improvement samples will support the change management process. Supplying the providers with an individual before and after scorecard or reading will prove the quality increase (within glycemic range) with the increase in moving sooner to best practice option two. I would suggest a reading at the three, six and 12-month marks. In the business world, privately communicating individual processor performance with a strong visual example before and incremental results after readings greatly supports aggregate change adoption.
--Maura Zigmont, 08-28-2012


Keith, I thought Jane might find this approach, if not the subject matter, relevant to her new role.
--Jane Corner, 08-08-2012


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