Literature DB >> 24052758

Improving Immunization Rates Using Lean Six Sigma Processes: Alliance of Independent Academic Medical Centers National Initiative III Project.

Hussaini Hina-Syeda1, Christina Kimbrough, William Murdoch, Tsveti Markova.   

Abstract

BACKGROUND: Quality improvement education and work in interdisciplinary teams is a healthcare priority. Healthcare systems are trying to meet core measures and provide excellent patient care, thus improving their Hospital Consumer Assessment of Healthcare Providers & Systems scores. Crittenton Hospital Medical Center in Rochester Hills, MI, aligned educational and clinical objectives, focusing on improving immunization rates against pneumonia and influenza prior to the rates being implemented as core measures. Improving immunization rates prevents infections, minimizes hospitalizations, and results in overall improved patient care. Teaching hospitals offer an effective way to work on clinical projects by bringing together the skill sets of residents, faculty, and hospital staff to achieve superior results.
METHODS: WE DESIGNED AND IMPLEMENTED A STRUCTURED CURRICULUM IN WHICH INTERDISCIPLINARY TEAMS ACQUIRED KNOWLEDGE ON QUALITY IMPROVEMENT AND TEAMWORK, WHILE FOCUSING ON A SPECIFIC CLINICAL PROJECT: improving global immunization rates. We used the Lean Six Sigma process tools to quantify the initial process capability to immunize against pneumococcus and influenza.
RESULTS: The hospital's process to vaccinate against pneumonia overall was operating at a Z score of 3.13, and the influenza vaccination Z score was 2.53. However, the process to vaccinate high-risk patients against pneumonia operated at a Z score of 1.96. Improvement in immunization rates of high-risk patients became the focus of the project. After the implementation of solutions, the process to vaccinate high-risk patients against pneumonia operated at a Z score of 3.9 with a defects/million opportunities rate of 9,346 and a yield of 93.5%. Revisions to the adult assessment form fixed 80% of the problems identified.
CONCLUSIONS: This process improvement project was not only beneficial in terms of improved quality of patient care but was also a positive learning experience for the interdisciplinary team, particularly for the residents. The hospital has completed quality improvement projects in the past; however, this project was the first in which residents were actively involved. The didactic components and experiential learning were powerfully synergistic. This and similar projects can have far-reaching implications in terms of promoting patient health and improving the quality of care delivered by the healthcare systems and teaching hospitals.

Entities:  

Keywords:  Graduate medical education; immunization; influenza–human; patient care team; pneumococcal vaccines; quality improvement; vaccination

Year:  2013        PMID: 24052758      PMCID: PMC3776504     

Source DB:  PubMed          Journal:  Ochsner J        ISSN: 1524-5012


  6 in total

Review 1.  Hospital-based influenza and pneumococcal vaccination: Sutton's Law applied to prevention.

Authors:  D S Fedson; P Houck; D Bratzler
Journal:  Infect Control Hosp Epidemiol       Date:  2000-11       Impact factor: 3.254

2.  Understanding the value added to clinical care by educational activities. Value of Education Research Group.

Authors:  G S Ogrinc; L A Headrick; J R Boex
Journal:  Acad Med       Date:  1999-10       Impact factor: 6.893

3.  Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23).

Authors: 
Journal:  MMWR Morb Mortal Wkly Rep       Date:  2010-09-03       Impact factor: 17.586

4.  Deaths: preliminary data for 2004.

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Journal:  Natl Vital Stat Rep       Date:  2006-06-28

5.  Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine.

Authors:  Tamara Pilishvili; Catherine Lexau; Monica M Farley; James Hadler; Lee H Harrison; Nancy M Bennett; Arthur Reingold; Ann Thomas; William Schaffner; Allen S Craig; Philip J Smith; Bernard W Beall; Cynthia G Whitney; Matthew R Moore
Journal:  J Infect Dis       Date:  2010-01-01       Impact factor: 5.226

6.  Mortality associated with influenza and respiratory syncytial virus in the United States.

Authors:  William W Thompson; David K Shay; Eric Weintraub; Lynnette Brammer; Nancy Cox; Larry J Anderson; Keiji Fukuda
Journal:  JAMA       Date:  2003-01-08       Impact factor: 56.272

  6 in total
  2 in total

1.  Preparing Academic Medical Centers for the Clinical Learning Environment Review: Alliance of Independent Academic Medical Centers National Initiative IV Outcomes and Evaluation.

Authors:  Hania Wehbe-Janek; Tsveti Markova; Rachael L Polis; Marguerite Peters; Yang Liu
Journal:  Ochsner J       Date:  2016

Review 2.  Team interventions in acute hospital contexts: a systematic search of the literature using realist synthesis.

Authors:  U Cunningham; M E Ward; A De Brún; E McAuliffe
Journal:  BMC Health Serv Res       Date:  2018-07-11       Impact factor: 2.655

  2 in total

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