Nursing Commons^™

Lean Implementation Difference Between Lean Maturity, Psychological Well-Being, And Employee Engagement Of Nurses In A Hospital Setting, Kevin E. Smith

Doctoral Dissertations and Projects

This quantitative study examined the differences of Lean implementation in three settings; (a hospital in a health system where Lean is implemented throughout the system, a hospital that has implemented Lean in a health system that has not implemented Lean, a hospital that has not implemented Lean in a health system that has not implemented Lean) between LM, PWB, and EE among nurses in a hospital setting. The theoretical construct of the job demands-resources model is used to base the study. Three survey instruments (Psychological Well-Being Scale, Utrecht Work Engagement Scale, Lean Healthcare Implementation Self-Assessment Instrument) were self-administered by registered …

Ultrasound Guided Piv Insertion Implementation, Blake Hotchkiss, Beth O'Donnell, Miles Merwin, Billie Jo Senecal, Ronica Smith, Eric Alan, Bryan Tavary, Chelsea Harkins, Taylor Archard, Leslie Geissinger, Lauren Remington

Operations Transformation

Observed high number of unsuccessful peripheral IV insertion attempts. This increases waste (cost and time) and decreases patient satisfaction.

Implementation Of Lean Principles During Operating Room Turnovers, Makenzie Marshall

Doctor of Nursing Practice Projects

Background

Many operating rooms across the country face the daunting task of making their turnovers between surgical patients quicker and more efficient. Turnover time is defined as the time it takes to clean an operating room and set up the next sterile field between surgical patients. The time begins when the patient leaves the operating room suite and stops when the next patient enters the same suite. Running an operating room is a complex and costly endeavor, and even small shortfalls can have a snowball effect, leading to delays, wasteful spending, and substandard patient outcomes; therefore, it is imperative to …

The Use Of Isbared/Ishaped And Elimination Of Reviewing Patients’ Chart Before Handoff To Decrease Incremental Overtime, Sheila Bucao

Master's Projects and Capstones

Problem: Incremental overtime was found to majorly impact the financial well-being of a stroke unit. From an allocated budget of 22 hours per pay period, the unit’s incremental overtime averaged 40 hours. The stroke unit had skilled-mix competencies, further complicating handoffs. The absence of a standard reporting method means that reviewing patients’ charts takes approximately 10 to 15 minutes, extending what should be a quick, but thorough nurse knowledge exchange.

Context: The body of evidence reviewed indicated that pertinent information to patient care is not left out or missed when a standardized tool is used during handoff. Based on Lean …

A Performance Improvement Nursing Fellowship To Enhance Timely Access To Care, Cheryl Reinking

Doctor of Nursing Practice (DNP) Projects

This scholarly report describes a Doctorate of Nursing Practice (DNP) project that advanced the performance improvement (PI) knowledge of frontline nurses to improve timely access to acute care during a 6-month PI/Lean management nursing fellowship. Patient flow issues delay access to care and result in negative patient quality outcomes and safety failures. Patient experience, confidence, and satisfaction in healthcare organizations erode when timeliness and efficiency are deficient. The project site is a 443-bed, two-campus, not for profit community hospital in Northern California. This project included the implementation of a PI/Lean nursing fellowship program as an evidence-based intervention to address patient …

Learning Lean To Lead, Krystle Irene Guenther

Doctoral Projects

This project sought to see if training frontline nurses and physicians together in Lean methodology improved collaboration between the two disciplines while giving them the tools they need to lead change at the bedside and in their practice. A quasi-experimental pre- and post-intervention methodology was used. The intervention was six, four-hour in-person modules on performance improvement (PI). Respondents completed two surveys, the performance improvement instrument and the Professional Practice Environment Assessment Scale (PPEAS). Surveys were paired for analysis. There was a statistically significant median increase in participants confidence for all questions on the PI instrument post-intervention. Results for the PPEAS …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Improving The Supply Process In An Interventional Procedures Unit, Megan M. Rose

Master's Projects

In the combined cardiac catheterization and interventional radiology unit of an urban Midwestern hospital, having supplies when and where they are needed is necessary for efficiently and safely completing a wide variety of procedures. Due to the complexity of the supply chain process in this setting, baseline data collection revealed many missing supplies, overnight shipments, and expired items. In this project, the MSN student sought to determine whether a Clinical Nurse Leader driven Lean Six Sigma based approach to supply chain interventions in the interventional procedures setting would improve outcomes and lead to financial savings by decreasing waste and variation. …

Lean And Six Sigma Impact On Operating Room Safety Attitudes And Efficiency, Nancy Marlene Geedey

Nursing Theses and Capstone Projects

Non-healthcare organizations have utilized Lean Six Sigma methodologies for several decades to eliminate waste, decrease expenses, and improve efficiency. This approach to problem-solving can be successfully applied to health care process improvement projects. Health care leaders and front line staff can use a prescribed set of steps to define steps in care processes and identify potential solutions. Health care leaders can use Lean Six Sigma tools such a fishbone diagram or a cause and effect matrix to identify issues. After carefully organizing the problems into groups according to priority, leaders can develop action steps toward resolution.

Predicting The Risk Of Obstructive Sleep Apnea And Difficult Endotracheal Intubation In A Surgical Population In A Rural Community Hospital Setting, Craig S. Atkins

DNP Projects

Purpose:

The purpose of this paper is to provide a theoretical framework with practical application for facilitating patient flow through the operative process using the Lean philosophy to minimized delays and cancellations.

Theoretical orientation:

Efficient, quality patient care has always been the hallmark of Nurse Anesthetist practice. Lean healthcare introduces continuous quality improvement (CQI) processes used in Lean manufacturing to the healthcare system. The principal aspect of Lean healthcare is the concept of a value stream where work is standardized, work flow is streamlined and waste is eliminated, thus creating value.

Nature of Review:

In the surgical suite waits, delays …