Reducing catheter-related bloodstream infections using Lean Six Sigma methodology

Area of Science:

• Nephrology
• Healthcare Quality Improvement
• Infectious Disease Prevention

Background:

• Central venous catheters (CVC) are essential for dialysis in end-stage renal disease but pose a risk of Catheter-Related Bloodstream Infections (CRBSI).
• While Lean Six Sigma is known to reduce CRBSI in intensive care units, its effectiveness in non-ICU hemodialysis settings is less understood.

Purpose of the Study:

• To assess the impact of the Lean Six Sigma methodology on reducing CRBSI rates among hemodialysis patients outside of intensive care units.

Main Methods:

• The study utilized the Define-Measure-Analyze-Improve-Control (DMAIC) framework from February to December 2021, establishing a benchmark CRBSI rate.
• Tools like value-stream mapping and Root Cause Analysis identified CRBSI drivers, guiding targeted interventions implemented in 2022.
• CRBSI rates were compared pre- and post-intervention.

Main Results:

• The implementation of Lean Six Sigma led to a significant reduction in CRBSI incidence, decreasing from 12.79 to 2.32 per 1,000 catheter-days.
• This statistically significant improvement (P=0.05) was observed between the periods of February-December 2021 and January-December 2022.

Conclusions:

• The Lean Six Sigma method is effective in reducing CRBSI in non-ICU hemodialysis patient populations.
• These findings support the broader application of Lean Six Sigma to improve safety and care in dialysis units.