Lean Six Sigma, originally developed by Toyota to build highly reliable and consistent cars (Lean) with powerful statistical tools to understand and improve business processes (Six Sigma), is far from just another fad improvement methodology. The dedicated team of Dietitians, Nurses, Physicians, and Nutrition Assistants at Mt. Washington Pediatric Hospital in Baltimore, MDused a Lean Six Sigma approach known as a Kaizen Event or Rapid Improvement Event to improve both the safety of its patients and the efficiency of its staff.
Mt Washington Pediatric Hospital (www.mwph.org) is a specialty hospital that provides family-focused, integrated care to infants and children. With 102 beds, and a large infant population, Mt. Washington’s clinical nutrition staff stays very busy. The team, comprised of 5 Pediatric Dietitians, several per diem Dietitians, 5 Nutrition Assistants, and a Clinical Nutrition Manager, is responsible for ensuring the nutrition needs of all patients are met. That’s a big job for a lot of small patients!
The Mt. Washington team is intensely focused on patient safety. As part of their improvement efforts, they transitioned to a new clinical nutrition information system in 2017. The new system, Timeless Medical Women & Infants, drastically improved diet management and tracking for Mt. Washington’s patients. But, it also brought with it the opportunity to re-examine all processes related to clinical nutrition, from the way nutrition products enter the building to the way in which breast milk is stored for neonatal patients.
With so many different processes and different departmental stakeholders, Mt. Washington knew they needed a different approach to tackling their problem. Working closely with Soriant Solutions, Mt. Washington embraced a Lean Six Sigma process known as a Rapid Improvement Event (RIE). This focused, short duration event was perfect for Mt. Washington because of its emphasis on engaging those who do the work in designing, testing, and implementing solutions in a rapid, Interactive learning environment.
The Mt. Washington team conducted two RIEs over a six-month period. The first was focused on the process of preparing, delivering, and providing nutrition products to patients. The second RIE was focused on the ordering, receiving, and stocking of nutrition products.
In the first event, the team focused on two major challenges: the timely implementation of diet order changes and the minimization of breast milk expiration. The multi-disciplinary team of Physicians, Nurses, Dietitians, Nutrition Assistants, and Information Technology Specialists first mapped the current state of the process, digging deep into the data to develop a thorough understanding of the process. Then they identified all the “waste” or problems in the systems. Next, they created a map of what they wanted the future to look like (future state map) and finally, they broke into teams to experiment directly in the workplace and refine their solutions. All of this took place over a three day period. The team then built an implementation plan to finalize the new processes over the next several weeks.
Not only did the team meet its goal of reducing the time between diet order changes submitted and implemented, while reducing breast milk expiration, they created noticeable changes in the environment. Figure 1 shows a before and after picture of the way nutrition products are stored for infants. Not only did this change improve safety by ensuring the right infant receives the right nutrition product, it also saved Nurses time and frustration searching for what they need, giving them precious time back with the babies for whom they care.
Figure 1: Infant Nutrition Refrigerator Changes
The team also had some fun in making improvements to the process for Moms to check in breast milk they pumped at home. In Figure 2, you can see the updated receiving station with a “happy” label printer reminding parents to avoid printer jams by “leaving his tongue out” along with the handy 24-hour clock to help parents convert 12-hour times to military format to enter into the system.
Figure 2: Updated Breast Milk Check-In Station
After the success of the first team, the second RIE team had big shoes to fill. That multi-disciplinary team tackled the receiving, storage, and stocking of nutrition products. The physical environment had become cluttered with excess inventory and lacked a good system for preventing product expiration.
RIE Team 2 also produced outstanding results, demonstrating reductions in product search times, reducing the number of products to only those needed, and reducing product expirations. One large improvement was to the way bulk inventory was managed in the warehouse. Figure 3 shows the noticeable change in organization and labeling from before to after.
Figure 3: Bulk Storage Changes
Overall, Mt. Washington’s staff used their creativity and knowledge to make significant changes to their processes during the Rapid Improvement Events. They showed that Lean Six Sigma works. And, they showed that partnering with Soriant was a good investment. Clinical Nutrition Manager, Donna Morris-Snoussi said, “The consultants at Soriant provided an invaluable service to us.”
If you’d like to learn more about Mt. Washington’s experience with Lean Six Sigma, please check out this 12-minute webinar describing their experience. And, if you want to learn more about how Soriant uses Lean Six Sigma in its engagements, please contact us. We’re excited to help you discover the innovativeness of your employees and reach your organization’s potential.