Lean six sigma to reduce pharmacy medication errors in Thai hospitals : an action research study

Hospital medication errors are costly and contribute to patient mortality, morbidity and decreased health care quality. Although healthcare organizations have endeavoured to reduce medication errors by using several approaches, the errors remained, returned or could not be resolved. The use of CI methodologies, such as Lean Six Sigma, can enable healthcare practitioners to ascertain the problems in the medication process and identify and eliminate the root cause of such problems. However, the existing literature does not address the need for an LSS roadmap in reducing medication errors; therefore, healthcare practitioners do not have an LSS roadmap to follow to reduce medication errors. This study aims to develop an LSS implementation and sustainability roadmap that can guide healthcare practitioners in the implementation of LSS to reduce medication errors. A systematic review was conducted to understand the benefits, challenges, and success factors of LSS implementation in reducing medication errors in a global context. The action research methodology was used to illustrate the employment of Lean Six Sigma through collaboration between the researcher and participants in an inpatient pharmacy of two public hospitals in Thailand. This study was carried out through action research based on the following key phases: identification of problems, reflection, planning action, taking action, evaluation, reflection and specify lessons learnt. The key finding of the systematic literature review revealed that Lean Six Sigma can be very useful on reducing medication errros in a hospital setting and improving patient care. The action research findings clearly show that Lean Six Sigma application improved the inpatient pharmacy dispensing process and contributed to reduced dispensing errors and enhanced patient safety. This is the first study that has developed an LSS roadmap which healthcare practitioners can follow to reduce medication errors using, LSS methodology and, and to sustain LSS in their organizations. This study provides a greater awareness for senior managers and medical directors in hospitals about the role of LSS and its associated tools and techniques in tackling medication errors. Future research can apply the roadmap in other hospitals to ensure its practical validity and enhance the application of LSS in the healthcare setting

An exploratory study into the use of Lean Six Sigma to reduce medication errors in the Norwegian public healthcare context

Purpose: Medication errors are a significant cause of injury in Norwegian hospitals. The purpose of this study is to explore how Lean Six Sigma (LSS) has been used in the Norwegian public health-care context to reduce medication errors. Design/methodology/approach: A mixed method approach was used to gather data from participants working in the four regions served by the Norway health authorities. A survey questionnaire was distributed to 38 health-care practitioners and semi-structured interviews were conducted with 12 health-care practitioners. Findings: The study finds that the implementation of LSS in the Norwegian public health-care context is still in its infancy. This is amidst several challenges faced by Norwegian hospitals such as the lack of top-management support, lack of LSS training and coaching and a lack of awareness around the benefits of LSS in health care. Research limitations/implications: Because of the large geographical area, it was difficult to reach participants from all health regions in Norway. However, the study managed to assess the current status of LSS implementation through the participants’ perspectives. This is a fruitful area for future research whereby an action research methodology could be used. Originality/value: To the best of the authors’ knowledge, this is the first empirical study into the use of LSS methodology in reducing medication errors. In addition, this study is valuable for health-care practitioners and professionals as a guideline to achieve the optimal benefit of LSS implementation to reduce medication errors

Can Lean Six Sigma be used to reduce medication errors in the health-care sector?

Purpose The purpose of this paper is to present the implementation of Lean Six Sigma (LSS) to reduce medication errors, by using four case examples. The paper will also suggest appropriate Lean and Sigma tools to improve the medication process. Design/methodology/approach The authors critically analyze four case examples that used LSS projects, to demonstrate the approach, benefits, success factors and lessons learnt. Findings LSS is a powerful process improvement methodology that could be applied by health-care sectors to reduce medication errors, increase patient safety and reduce operational costs. Common Lean and Six Sigma tools play a significant role in improving and sustaining the medication process. Practical implications It is necessary for the project team to select the most appropriate LSS tools to address medication process problems. Adoption of a LSS roadmap could help health-care organizations in the successful implementation of LSS. Originality/value The paper is valuable for health-care professionals seeking to reduce errors in the medication process or other processes that need to be improved. </jats:sec

Reducing medication errors using lean six sigma methodology in a Thai hospital:an action research study

Abstract Purpose The purpose of this paper is to illustrate the use of Lean Six Sigma (LSS) and its associated tools to reduce dispensing errors in an inpatient pharmacy of a teaching hospital in Thailand. Design/methodology/approach The action research methodology was used to illustrate the implementation of Lean Six Sigma through the collaboration between the researcher and participants. The project team followed the Lean Six Sigma Define, Measure, Analyze, Improve, Control (DMAIC) methodology and applied its tools in various phases of the methodology. Findings The number of dispensing errors decreased from 6 to 2 incidents per 20,000 inpatient days per month between April 2018 and August 2019 representing a 66.66% reduction. The project has improved the dispensing process performance resulting in dispensing error reduction and improved patient safety. The communication channels between the hospital pharmacy and the pharmacy technicians have also been improved. Research limitations/implications This study was conducted in an inpatient pharmacy of a teaching hospital in Thailand. Therefore, the findings from this study cannot be generalized beyond the specific setting. However, the findings are applicable in the case of similar contexts and/or situations. Originality/value This is the first study that employs a continuous improvement methodology for the purpose of improving the dispensing process and the quality of care in a hospital. This study contributes to an understanding of how the application of action research can save patients' lives, improve patient safety and increase work satisfaction in the pharmacy service.peer-reviewe

Reducing pharmacy medication errors using Lean Six Sigma: A Thai hospital case study

Hospital medication errors are costly and contribute to patient mortality, morbidity, and decreased health care quality. Errors result from poor systems design more commonly than from healthcare staff performance. As such, a focus should be directed to process design. This action research study examines the application of Lean Six Sigma to reduce inpatient pharmacy dispensing errors in a Thai public hospital. Through the successful application of multiple Lean Six Sigma tools, the implementation of Lean Six Sigma reduced monthly dispensing errors from 29 incidents to 6 incidents over 14,000 total inpatient days between March 2018 and November 2019, and improved patient safety. Lean Six Sigma tools used in this study were cause-and-effect diagrams, spaghetti diagrams, five-why analysis, project charters, brainstorming, control charts, and hypothesis testing. This case study can improve hospital manager and medical director awareness of Lean Six Sigma and its benefits relative to the prevention and reduction of medication errors.peer-reviewed2022-09-0