Implementing lean six sigma to optimize emergency extracorporeal cardiopulmonary resuscitation process management

The aim of this study is to evaluate the effectiveness of lean six sigma management in optimizing the emergency extracorporeal cardiopulmonary resuscitation (ECPR) rescue process.

The existing ECPR emergency rescue process was optimized using the lean six sigma methodology, which follows the five phases of six sigma: Define, measure, analyze, improve, and control. Lean management principles were integrated throughout the process. Performance indicators evaluated before and after implementation included the percentage of medical staff achieving a perfect score in assessment, the excellence rate of surgical records, the incidence of adverse events, and the time required for each phase of the ECPR emergency rescue process.

No statistically significant differences were observed in demographic characteristics between the pre- and post-implementation groups (p > 0.05). Following the implementation of lean six sigma management, both the percentage of medical staff achieving perfect scores and the excellence rate of surgical records demonstrated significant improvement. Additionally, the incidence of adverse events, including those related to backup medications, equipment, puncture procedures, team coordination, and patient transport, decreased significantly. Process optimization led to a reduction in the duration of each phase of the emergency rescue process compared to the control group, except for the time required to initiate conventional cardiopulmonary resuscitation (CCPR). Specifically, the time from CCPR initiation to ECPR activation decreased from 34.03 ± 18.55 min to 23.25 ± 13.11 min, while the time from cardiac arrest onset to successful extracorporeal membrane oxygenation circulation decreased from 73.46 ± 16.33 min to 48.86 ± 13.30 min, both of which were statistically significant (p < 0.05).

The application of lean six sigma management effectively standardized the emergency ECPR rescue process, resulting in improved quality of emergency ECPR care. The optimized process significantly reduced the duration of emergency ECPR interventions.