The January 2015 issue of the Joint Commission Journal on Quality and Patient Safety features an article about how performance improvement and infectious disease experts from eight U.S. hospitals used Lean Six Sigma techniques to reduce the rate of healthcare-associated infections. The article entitled “Improving Hand Hygiene at Eight Hospitals in the United States by Targeting Specific Causes of Noncompliance” details the nearly two-year project and its results. Consider the highlights.
Project Logistics and Data
Between December 2008 and September 2010 teams from eight hospitals worked together, using Lean Six Sigma methods to measure hand hygiene noncompliance, identify the causes of noncompliance, develop and test ways to correct the identified failures and identify ways to sustain the improved levels of performance. The eight hospitals averaged a compliance rate of only 47.5 percent with 41 identified causes of hygiene failure. Since the causes of noncompliance varied, each hospital developed its own compliance intervention strategy. At the end of the project, all eight hospitals averaged a 70.5 increase in compliance, with the most successful hospital seeing an 81 percent increase.
The benefits of Lean Six Sigma were not limited to the eight hospitals involved in the project. After completing the project, the original team worked with 19 more hospitals through Web-based tools. Even though the additional hospitals did not have Lean Six Sigma experience, they were able to identify hand hygiene failures and implement interventions using the same methods through the Targeted Solutions Tool®. Over the past three years, 289 healthcare organizations have used this Web-based solution to implement 1,495 projects to improve hand hygiene compliance. At the time of writing, data was available for 769 of these projects. The average compliance improvement ranged from 57.9 to 83.5 percent. Details about this ongoing project are also outlined in the January issue of the Joint Commission Journal in an article entitled “Beyond the Collaborative: Spreading Effective Imp rovement in Hand Hygiene Compliance.”
How Lean Six Sigma Helps
Those familiar with Lean Six Sigma know its principles apply across all industries. Consider just a sampling of Lean Six Sigma applications to this project.
- Identify physician and nurse leadership in each unit.
- Have a project steering team that regularly meets to discuss progress.
- Get backing from administrative support and ensure they are kept in the loop.
- Both clinical and non-clinical staff should be included in education and communications.
- Maintain awareness and motivation through regular feedback.
- Education should be repeated, so it is fresh.
- Keep instruction simple.
- Use visual reminders.
- Teach using realistic demonstrations.
- Expect challenges.
- Be patient and persistent.