SCVMC Waste Elimination Using the Lean Six Sigma Methodology
Topic of Interest
Interprofessional Collaboration
Abstract
Purpose: This process improvement project was implemented to decrease unnecessary or inappropriate dispensing of Z-Flo Fluidized Positioners.
Relevance/ Significance: Use of Z-Flo Fluidized positioner is an essential component of hospital-wide pressure injury prevention bundle for all patients with Braden score ≤18. Due to this, some patients determined low risk for pressure injury based on ability to self-position, ambulate appropriately within two to three days and have shorter length of stay have been ordered positioners inappropriately leading to unnecessary financial waste. Between August 2018 and May 2019, the hospital spent $437,000 on Z-Flo Fluidized positioners.
Strategy and Implementation: A multidisciplinary taskforce, led by the Clinical Nurse Specialist, for waste reduction was created and using a Lean Six Sigma methodology, the DMAIC principle (Define, Measure, Analyze, Improve, Control), created an evidence-based algorithm for decision-making prior to ordering the positioners a collaborative approach to waste reduction. Education provided to nursing and central supply staff on the inclusion criteria and the use of a checklist as part of the ordering process. To ensure compliance, central supply monitored department usage monthly and presented to taskforce members.
Evaluation/Outcomes: Pre-implementation positioner expenses from January to June 2019 was $236,909 and post-implementation expenses from January to June 2020 was $76,146, a 68% reduction and total savings of $160, 763. Furthermore, HAPI Stage II and above (excluding device-related) was monitored to ensure quality outcomes were not compromised. The number decreased from 4 in January to June 2019 to 3 in January to June 2020.
Implications for Practice: Simple cost-saving processes can lead to substantial reductions in costs while maintaining high levels of quality.