Optimizing nursing time in a day care unit: Quality improvement using Lean Six Sigma methodology.

Objective: This study applies Lean Six Sigma (LSS) to improve the efficiency of a private hospital day care unit and generate a positive impact on optimizing nursing time and improving personalized patient care and staff satisfaction.

Design: A prospective interventional study using pre- and post-evaluation.

Setting: A day care unit at a private hospital.

Participants: Nurses and patients from the day unit.

Intervention(s): Define, Measure, Analyze, Improve and Control was used as an overarching problem-solving framework. All front line staff, clinical leaders and managers were supported as active change agents in the quality improvement (QI) initiative. Multiple interventions were adopted across the service that aimed to de-implement non-value added activities and enhance processes with activities that added value.

Main Outcome Measures: Patient turnaround times (PTTs), nursing time, nurse-patient ratio, nurse and patient survey.

Results: A post-implementation evaluation highlighted significant improvements in service performance and patient and staff satisfaction. Significant added value includes a reduction in PTTs, an increase in nursing care time and improvement in the nurse-patient ratio.

Conclusion: This project identified that utilizing LSS that relies on collaborative team effort is effective in creating a positive organizational culture for improvement and change. The Six Sigma tools and techniques provide evidence-based approaches that support QI in practice.