Already faced with pressure to provide cost-effective patient care, leaders in the healthcare industry saw their challenges quickly compounded when the coronavirus pandemic swept the globe in 2020.

But one hospital in Ireland found that putting Lean Six Sigma to use during the crisis not only helped patients, but also better protected staff, saved costs and reduced environmental damage.

The hospital, Children’s Health Ireland at Crumlin in Dublin, Ireland, focused on reducing waste during COVID-19 testing for children undergoing congenital cardiac surgery. They did so by implementing DMAIC and Value Stream Mapping.

After a three-week implementation period, the hospital attained the following results:

  • Reduced the number of sets of personal protective equipment used from 13 to one per patient, which equates to savings of more than 36,000 pounds per year
  • Reduced the number of staff members exposed to patients with unknown COVID-19 status from 13 to one per patient
  • Reduced single-use plastic waste by about 70,000 items per year.

The results provide yet another example of how Lean Six Sigma can make healthcare operations more efficient. But it’s a lesson that is applicable to all industries.

New Ways of Applying Lean to COVID-19 Challenges

In a paper on the Lean Six Sigma implementation, hospital leaders wrote that they went into the project already knowing Lean Six Sigma has proven effective in eliminating waste and improving value to patients and healthcare providers. They wanted to apply these ideas specifically to challenges surrounding patient care during the coronavirus.

They also knew they faced an ongoing, global shortage in the PPE needed to treat patients during the pandemic. As the largest pediatric hospital in Ireland, conducting more than 528 cardiothoracic procedures per year and serving a population of 1.2 million children, they also knew the shortage could have a big impact on their operations.

That’s because every child must be tested before starting a procedure. Operating on infected children could lead to dangers for both the patient and hospital staff.

Hospital managers used DMAIC, one of the most popular methodologies in Six Sigma, as a framework for the project. DMAIC stands for define, measure, analyze, improve and control. Here’s an overview of how it worked in this case.

Define – The primary outcome of the project was to reduce the amount of PPE needed per patient, as well as limiting staff exposure to the coronavirus. Additional goals included cost savings and environmental improvements.

Measure – The hospital set success metrics for different areas involved with the testing process. To get there, they used Value Stream Mapping to create detailed visuals on the admissions pathway for children scheduled for congenital cardiac surgery.

Analyze – By analyzing the data, the hospital found 13 potential close contact points with patients that required PPE.

Improve – A new pathway was devised, again using Value Stream Mapping.

Control – Every patient’s progress through the new pathway is monitored and recorded using electronic healthcare records (the hospital uses Mediplus 2013) to ensure the new system is working.

Success Meant Safer Patients and Staff

The doctors at Children’s Health Ireland wrote that the study “demonstrates how Lean methodology using DMAIC and Value Stream Maps can eliminate non‐value added (waste) steps in SARS‐CoV‐2 testing, without additional cost.”

The use of Lean Six Sigma may also have saved lives. As noted in the report, without the new pathway devised using Lean Six Sigma tools, the hospital could have admitted children who were positive for COVID-19.

“This is a serious safety concern and could cause significant morbidity to the patient undergoing cardiac surgery, to staff exposed, and to other patients in the hospital,” they wrote.

As part of their report, leaders from the hospital also listed other cases where hospitals put Lean Six Sigma to use. They included an Italian hospital that used Lean to reduce radiology turnaround times for the emergency department and a Wisconsin healthcare delivery system that used Lean to make management more proactive and less reactive.