The Lean Nurse

Six SigmaIn order to squeeze waste out of the health care system, campaigns have been developed mostly on two fronts, informing both providers and receivers of care about the actions they can take to hold down increasing spending. For example, through education and information, Costs of Care aims to get both doctors and patients to reject unnecessary medical tests and treatments. There’s also Choosing Wisely, which encourages patients to start conversations with their doctors along the same lines. On a third front for nurses, there is Lean Six Sigma.

Lean Six Sigma isn’t actually a formal campaign. It’s a managerial strategy meant to help businesses eliminate process waste, and it’s the basis for a proposed course at the College of Nursing at the University of Alabama in Huntsville. The curriculum is being developed by two UAH associate professors, one in the nursing school and one in the School of Industrial and Systems Engineering and Engineering Management.

Lean Six Sigma incorporates ideas from both the Lean and Six Sigma methodologies. Lean’s goal is to eliminate waste while Six Sigma aims to streamline processes. In the context of health care, it’s easy to imagine that these manufacturing methods promote conveyor belt medicine, encouraging nurses to see patients one by one without paying attention to the individuals and their varied needs.

On the other hand Lean Six Sigma applied to health care is, by definition, patient-focused. That’s because the strategy calls for identifying what customers, in this case patients, define as quality and then using that as a performance measure. For example, since patients value shorter wait times, part of a medical facility’s success would be determined by how well they keep wait times low.

“The worst thing I could do with doctors and nurses is to talk about widgets. They appreciate every patient’s uniqueness. But this system can show them how to be more efficient while they treat that patient,” Sampson Gholston, PhD, an engineer and one of the developers of the proposed course, said in a news release.

His co-developer, Peggy Hays, DSN, of the nursing school said that the goal of the course is to make use of the wealth of data now being collected by medical institutions. It will train administrators and nursing staff how to interpret data and then implement the necessary process changes in order to improve patient satisfaction.

“Nursing staff today have more and more duties,” Hays said. “How can they make their job more efficient so they can focus on patient care, which is why they got into the profession in the first place?”

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