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Possible causes of catheter infection 

Possible causes of catheter infection 

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Purpose – Delays, measurement and medical errors and variability often undermine the delivery of safe, effective patient care. However, it is possible to minimize them by applying six‐sigma. This methodology aims to focus on the root causes of healthcare problems, analyses them by flowcharts and fishbone diagrams and produces near‐perfect healthcar...

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... needed to identify factors influencing the occurrence of catheter infection was gathered through this working team; through assessment sessions conducted and via observations conducted during the catheter insertion and maintenance procedures. 20,4 This process resulted in the development of the fishbone diagram, which highlighted the patient, equipment, healthcare personnel and environment which impact the catheter infections ( Figure 6). ...

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The research work aims to develop a road map for analysis phase during Six Sigma implementation in Rajiv Gandhi Thermal Power Plant located at Hisar (Haryana, India). Six Sigma is a methodology for pursuing continuous improvement in customer satisfaction and profit that goes beyond defect reduction and emphasises business process improvement in gen...

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... A Six Sigma (SS) methodology was applied in the study. In previous years, many researchers have applied an SS methodology to analyze clinical pathways in different fields of medicine [52][53][54]. Apart from medical procedures, LSS also facilitates administrative management, including medical recordkeeping, finance management, patient hospitalization and discharge forms and medical equipment coding [52]. In this work, we will analyze changes in terms of length of hospital stay (LOS), mode of discharge and diagnosis related group (DRG) relative weight. ...
... In previous years, many researchers have applied an SS methodology to analyze clinical pathways in different fields of medicine [52][53][54]. Apart from medical procedures, LSS also facilitates administrative management, including medical recordkeeping, finance management, patient hospitalization and discharge forms and medical equipment coding [52]. In this work, we will analyze changes in terms of length of hospital stay (LOS), mode of discharge and diagnosis related group (DRG) relative weight. ...
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Background: In health, it is important to promote the effectiveness, efficiency and adequacy of the services provided; these concepts become even more important in the era of the COVID-19 pandemic, where efforts to manage the disease have absorbed all hospital resources. The COVID-19 emergency led to a profound restructuring—in a very short time—of the Italian hospital system. Some factors that impose higher costs on hospitals are inappropriate hospitalization and length of stay (LOS). The length of stay (LOS) is a very useful parameter for the management of services within the hospital and is an index evaluated for the management of costs. Methods: This study analyzed how COVID-19 changed the activity of the Complex Operative Unit (COU) of the Neurology and Stroke Unit of the San Giovanni di Dio e Ruggi d’Aragona University Hospital of Salerno (Italy). The methodology used in this study was Lean Six Sigma. Problem solving in Lean Six Sigma is the DMAIC roadmap, characterized by five operational phases. To add even more value to the processing, a single clinical case, represented by stroke patients, was investigated to verify the specific impact of the pandemic. Results: The results obtained show a reduction in LOS for stroke patients and an increase in the value of the diagnosis related group relative weight. Conclusions: This work has shown how, thanks to the implementation of protocols for the management of the COU of the Neurology and Stroke Unit, the work of doctors has improved, and this is evident from the values of the parameters taken into consideration.
... LSS can help in solving process-related problems by matching the right tool with the right problem. LSS tools such as "5 S" (Tolga Taner et al., 2007) can be efficiently used for the management of personal protective equipment's (PPE'S), disinfectants, ensuring timely availability of sterilizers or handwash, designing better process flow for infection detection with the help of value stream mapping (VSM) (Kieran et al., 2017), applying pokayoke or error-proofing for test results and giving importance to telehealth for error-proofing as risk minimization strategy (McDermott et al., 2021). There are some review studies on six-sigma, focusing on the evolution of LSS and identification of the research gaps (Hendry and Nonthaleerak, 2005;Jones and Johnson, 2009;Niñerola et al., 2019a). ...
... There are some review studies on six-sigma, focusing on the evolution of LSS and identification of the research gaps (Hendry and Nonthaleerak, 2005;Jones and Johnson, 2009;Niñerola et al., 2019a). Moreover, there are LSS review studies specific to industries such as healthcare (Tolga Taner et al., 2007) and manufacturing (Saja et al., 2013;Sordan et al., 2020). Few researchers have focused on LSS applications concerning a particular country (Walter and Paladini, 2019) or a journal (Ciano et al., 2019) and continuous improvement projects (Gonzalez Aleu and Van Aken, 2017). ...
... Moreover, thematic analysis results suggest that LSS applications in healthcare have evolved as a niche theme in the last few years. Previous studies resonate the same by suggesting the growth of LSS applications in healthcare in the coming years (Tolga Taner et al., 2007). ...
Purpose This study examines the research landscape of Lean Six-Sigma (LSS) applications in hospitals for the period of the last decade (2011–2020) to derive answers to the research questions RQ 1: What are the current publication trends for the application of LSS in hospitals concerning document type, Journal (Source), active authors and country-wise publications and their comparison in the two most reputed scientific databases, i.e. Scopus and Web of Science (WoS), RQ2: What are the clusters based on the authors and keywords? RQ3: What are the research trends and author's productivity in LSS applications in Hospitals? RQ4: What are the future research areas? Design/methodology/approach This article compares these two databases (Scopus and WoS) based on publication pattern, document type, active authors and co-citation analysis. This article analyzes the core sources, author's productivity, globally cited articles, word growth analysis, thematic map and world collaboration map on the WoS and Scopus dataset. The software used are Vosviewer, Biblioshiny ( R Package for Bibliometric) and M.S. Excel. Findings The application of LSS in hospitals is a niche theme. In the WoS database International Journal of Lean Six - Sigma and in Scopus database International Journal of Health Care Quality Assurance are the most relevant sources publishing research articles in this field. The USA has the highest scientific production in this field. Among the authors, Antony J is the most active author in this area, with the highest contribution over the years. Originality/value This study fills the literature gap by mapping the field of LSS in hospitals.
... Lean is a set of operating philosophies and methods that help create maximum value for patients by reducing waste and waits [10]. The approach has been developed from the automobile and manufacturing industries, and is a continuous process improvement system, comprising structured inventory management, waste reduction, and quality improvement techniques [11]. Lean utilises a continuous learning cycle that is driven by the 'true' experts in the processes of healthcare, i.e., the patients/families, healthcare providers, and support staff [12]. ...
... Brown et al. (2019) used LSS methodologies to improve their rate of day of surgery admission from 10 to 75% over a 19-month period, while reducing the duplication of perioperative tests from 83 to <2% [24]. LSS has also been shown to be effective in a paediatric hospital setting to decrease turnover and turnaround time [11]. Furter (2018) used LSS methodology to reduce the length of stay by 30% in 3 months in their emergency department, and increased patient satisfaction from 24% to 89.9% [25]. ...
... We found that the majority of the non-value added was in the overnight stay (it accounted for 54% of the patient's time in the hospital). The data from our audits and process maps were analysed using a modified fishbone diagram to carry out a root cause analysis on the non-value added identified from these methods [11]. ...
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... In the 80s of the last century, the Six Sigma was a statistical technique for reducing defect to 3.4 dpmo in industry, but organisations have sought to add new dimensions to this technique and to use it in other sectors. These dimensions were represented in the DMAIC cycle: customer orientation, commitment to employees, gaining skills to solve problems, building and developing a quality culture and adopting the Six Sigma as a strategy to create a competitive advantage (Gowen et al., 2012) through reducing defect to 3.4 dpmo and improving the quality for market excellence in the industry and services as well as in digital services and software development (Taner et al., 2007). The Six Sigma has gained increasing importance through its applications in different sectors. ...
... However, a large body of literature does exist on these topics elsewhere that can be applied here. For instance, " Antony (2008), , , Bhasin (2012), Chakravorty (2009), Hilton and Sohal (2012), Kwak and Anbari (2006), Martinez-Jurado and Moyano-Fuentes (2014), , Pedersen and Huniche (2011), Pinto et al. (2008), Serrano Lasa et al. (2009) and Tolga Taner et al. (2007". Albliwi et al. (2014) also assert that lack of training and education are CSFs of LSS deployment. ...
... They suggested new procedure and protocols, which reduced average LOS from 11.9 hours to 3.4 hours. Taner et al. [8] improved the Magnetic Resonance Imaging (MRI) quality by using Six Sigma. They found that the main reason for variations in diagnostic imaging process was due to the inadequately trained observer/ technician. ...
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... Organizations face pressure to sustain a quality service and deliver change while achieving operational and strategic excellence and keeping the service patient-focused [75]. Therefore, it is essential that internal strategies focus on quality improvement initiatives that align with organizational goals and identify meaningful performance metrics [76]. This finding is practically important so that organizations do not assume that external strategies are sufficient and that internal investment is also required to support implementation. ...
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Quality measurement initiatives promote quality improvement in healthcare but can be challenging to implement effectively. This paper presents a Rapid Realist Review (RRR) of published literature on Quality Care-Process Metrics (QCP-M) implementation in nursing and midwifery practice. An RRR informed by RAMESES II standards was conducted as an efficient means to synthesize evidence using an expert panel. The review involved research question development, quality appraisal, data extraction, and evidence synthesis. Six program theories summarised below identify the key characteristics that promote positive outcomes in QCP-M implementation. Program Theory 1: Focuses on the evidence base and accessibility of the QCP-M and their ease of use by nurses and midwives working in busy and complex care environments. Program Theory 2: Examines the influence of external factors on QCP-M implementation. Program Theory 3: Relates to existing cultures and systems within clinical sites. Program Theory 4: Relates to nurses’ and midwives’ knowledge and beliefs. Program Theory 5: Builds on the staff theme of Programme Theory four, extending the culture of organizational learning, and highlights the meaningful engagement of nurses and midwives in the implementation process as a key characteristic of success. Program Theory 6: Relates to patient needs. The results provide nursing and midwifery policymakers and professionals with evidence-based program theory that can be translated into action-orientated strategies to help guide successful QCP-M implementation.
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