Lean Six Sigma in Healthcare Eliminates Potentially Life-Threatening Prescription Errors

lean six sigma prescription errors

As a lean consultant, there’s nothing more concerning than hearing about issues that could potentially cost people’s lives, yet were totally avoidable with the right amount of planning. Recently, I consulted with a local hospital that performed a quality management audit and found that their margin for prescription error was incredibly high. Patient care was suffering. They decided to hire a lean six sigma consultant to assess their current processes. They needed to determine what practices and policies should be established in order to reduce the percentage of medication error.

The consulting project first employed the six sigma quality improvement model of DMAIC (Define, Measure, Analyze, Improve, Control) to determine where to focus efforts, and simultaneously trained key members of staff in the six sigma method. The staff created a quality improvement group that consisted of several employees from various occupations that would be directly affected by policy changes.

After defining the problem, they measured their baseline for standards and began to track prescription errors.  Upon completing their analysis of the root causes, the team implemented a series of processes that greatly reduced the percentage of medication error. The result was a decrease in prescription error, an improvement in patient safety, overall savings on labor costs, and an increase in staff morale.

The Hospital Prescription Process

In 1999, the National Academy of Science Institute of Medicine issued a report that brought the frequency of medical errors and endangerment of patient safety to the public’s attention. Until then, no one realized how flawed the system truly was. The healthcare system is at high risk—specifically when it comes to prescription error and patient safety. Here’s a closer look at the main steps in the hospital prescription process, with each one representing a potential touch point for error:

  • Selecting and procuring the medication
  • Storing
  • Ordering and transcribing
  • Preparing and dispensing the medication
  • Administration
  • Monitoring the patient for side effects

In order to understand the issue and mitigate risk, a healthcare organization has to figure out how to quantify the errors. They need to adopt a process that measures the error rate in medication administration records (MARs). These are generally the metrics measured when assessing a hospital’s percentage of prescription error. Although difficult to implement, a statistic-based process like lean six sigma has proven to be incredibly successful in terms of patient safety.

What Is Lean Six Sigma?

Lean strategies in the healthcare industry are incredibly effective because they focus on eliminating waste and setting standards for continuous improvement. The Six Sigma method takes the process a step further by assigning a quality improvement model to reduce the chances of error to as close as 3.4 defects per million parts. The six sigma improvement model contains a 5-step approach to problem-solving that provides a quantitative solution for patient safety and eliminating prescription error. It is known as DMAIC and includes the following components:

  • Define: This step asks the question of “who are your patients and what do they want?” This stage provides objectives for improvement efforts and project planning.
  • Measure: This step calculates the baseline that metrics will be calculated against. It looks at the characteristics that reflect improvement in patient satisfaction.
  • Analyze: Specific software and tools are used to analyze the data collected in the previous step. Everything from flow diagrams to process charts can be used to determine potential areas of prescription error.
  • Improve: All system modifications and design changes are identified and resources are allocated towards improving those processes.
  • Control: To ensure performance improvements are sustainable (particularly with medication errors), changes are monitored using statistical process control charts and quality management tools.

Prescription error is one of the most costly mistakes a hospital can make, particularly when it comes to a patient’s life. Using a refined method of organization and analysis like lean six sigma ensures that careful and calculated steps are taken to eliminate error. Lean six sigma provides a structured methodology with statistical tools that make for a powerful approach to enhancing patient safety and reducing prescription error.

Using Lean Six Sigma to Eliminate Error

Six Sigma is highly measurable and driven by data. Therefore, a healthcare organization must employ the proper tools and processes to successfully implement a program.

Implement the right technology solutions: In order to achieve a low margin of prescription error, the ability to analyze statistical data is important. Lean six sigma often calls for a redesign of systems and process maps. Employing software that flags mistakes and creates real-time data allows staff to take immediate corrective action. Here are a few types of technology hospitals use to reduce prescription error:

  • Computerized Physician Order Entry (CPOE)
  • Electronic Medication Reconciliation
  • Bar Code Medication Administration (BCMA)

Set high performance standards: In order to maintain the high standards required by lean six sigma initiatives, instruction and supervision are imperative. These types of management systems can be tough to institute, and can bring forth a wave of culture change. Using the proper technology when implementing a six sigma approach will ensure that on-the-job and instant correction and praise can be given for the most effective outcomes.

Hospital systems are complex, and there is no room for mistakes when it comes to patient medication. Lean six sigma is an incredibly powerful method when it comes to defining, quantifying, analyzing, and controlling a prescription process. Through extensive staff training and the proper technologies, any healthcare organization can reduce prescription error while keeping their patients safely medicated.

Are you interested in learning how lean six sigma and other approaches to lean healthcare can help your hospital avoid errors? Contact Incito Consulting today to arrange for a personalized consultation and to learn more about how our experienced staff works with healthcare leaders to address their most important strategic challenges.