A not-for-profit healthcare system found that adherence to clinical quality observed metrics for inpatient heart failure discharge instruction was consistently below national standards. Working toward a goal of increasing the observed rate of compliance from 45.3% to at least 90% by January 2008, the improvement team used the Six Sigma DMAIC (define, measure, analyze, improve, control) approach and Pareto analysis to identify potential failures and the vital factors contributing to the problem. Strategies developed to counter the vital signs and improve the process included standardizing the discharge process across all nursing units, standardizing the most effective type of discharge instruction, improving the knowledge level of heart failure discharge instruction elements unit-by-unit with one-on-one training, and standardizing and simplifying the heart failure discharge instruction process. Based on a three-month pilot, the project succeeded in reaching its goal of a 90% compliance rate with heart failure discharge instruction.

1-      What are the tools / techniques used in operations management to improve quality? illustrate with at least three examples.

2-      Analyze how lean management tools will be beneficial to the hospital to enhance the hospital discharge policy? You may use diagram to discuss the patient flow from admission to discharge. Discuss key factors that hinder smooth and effective patient discharges in any healthcare setting.

3-      How can Lean and Six Sigma be applied to improve healthcare operations, considering the differences in concept and approaches of each of them.

Reference:   DeFeo, Joe; Ralston, J. Er : Increasing the Percentage of Heart Failure Patients Who Receive Heart Failure Discharge Instruction; Healthcare Division, The Global Value of Quality 2009