Using a Lean Six Sigma Approach to Yield Sustained Pressure Ulcer Prevention for Complex Critical Care Patients.

Area of Science:

• Healthcare Management
• Quality Improvement Science
• Patient Safety

Background:

• Medicare's value-based purchasing penalizes hospitals for hospital-acquired pressure ulcers (HAPUs), creating a need for effective prevention strategies.
• Nurse managers face challenges in identifying evidence-based interventions for HAPU prevention due to limited validated processes.
• The study addresses the critical need for robust HAPU prevention methods in acute care settings.

Purpose of the Study:

• To decrease the unit-acquired pressure ulcer (UAPU) rate by 15% in intensive care and step-down units.
• To implement and evaluate Lean Six Sigma (LSS) methodology as a framework for pressure ulcer prevention.
• To establish a sustainable process for reducing hospital-acquired conditions.

Main Methods:

• An interdisciplinary team utilized Lean Six Sigma (LSS) methodology for a pilot intervention program.
• Key interventions included standardized documentation, equipment monitoring, patient out-of-bed-to-chair protocols, and a rounding checklist.
• A pilot program and subsequent control phase were employed to assess intervention effectiveness.

Main Results:

• The UAPU rate decreased from 4.4% to 2.8% during the pilot phase, surpassing the 15% reduction goal.
• The UAPU rate remained below the target goal at 2.9% during the program control phase.
• A statistically significant reduction in UAPU rates was achieved post-intervention.

Conclusions:

• The implemented program effectively reduced UAPU rates in high-risk patient populations.
• Lean Six Sigma (LSS) offers a sustainable and effective approach for decreasing hospital-acquired conditions.
• Broader testing and implementation of LSS methodologies are recommended for widespread adoption in healthcare.