The military continues to lead the way among government agencies in putting Lean Six Sigma to work in making operations more effective and efficient. The latest example comes from Hawaii, where a Naval health clinic has made the delivery of prescription medications safer.

The Naval Health Clinic Hawaii recently won the inaugural process improvement essay competition run by Navy Medicine West. The award, called the Captain Cheryl C. Ringer Memorial Award, is named after an officer who focused on process improvement throughout her 22-year military career.

The award honors those who use process improvement to “enhance delivery of patient care, streamline administrative support processes and improve the quality of all healthcare services.”

Lean Six Sigma and Healthcare

Lean Six Sigma is becoming a staple in the healthcare industry. The methodology has been put into use by everyone from spinal surgeons looking to improve patient outcomes to healthcare companies training their entire staff in Lean Six Sigma.

This also is not the first time a Navy hospital has been awarded for implementing Lean Six Sigma. The Naval Hospital Bremerton in Washington has twice received accolades for its success at process improvement. This included the creation of a Medical Records Data Automation Program that saved 7,300-man hours a year and $156,400 in costs.

In Hawaii, the issue that needed addressing involved the dosage of medication based on a patient’s weight. The clinic wanted to standardize this process to ensure patient safety, especially in children.

Putting Lean to Use

One of the leaders on the Naval Health Clinic Hawaii project was Lt. Cmdr. Vince Deguzman, the pharmacy department head and a Lean Six Sigma Black Belt. In a statement, Deguzman said the award “validated” the clinic’s commitment to continuous process improvement and high reliability standards.

To address the medication issue, Naval Health Clinic Hawaii first put together what amounted to a Kaizen Event to begin a rapid improvement project. They invited experts to focus on defining the issue and developing a solution.

In this step, they covered all the bases. The panel included pediatricians, family medicine providers, biomedical staff, pharmacists, nurses, corpsmen and administrators.

The group created a number of solutions to address the dosage issue:

  • Standardizing practices for prescribing pediatric prescriptions
  • Using only kilograms for measuring patient weight
  • Consistently documenting weight and dosing information (milligram per kilogram) in the health records of pediatric patients
  • Ensuring pharmacies only would accept prescriptions written in the standardized format
  • Implementing a visual aid (a growth chart) that reminds providers what information to use when prescribing medications

Winning the Award

The Navy makes writing an essay a part of winning the Ringer Award because they want those involved to demonstrate an ability to get across both how they accomplished a project and the benefits achieved.

Rear Adm. Paul Pearigen, NMW commander and chief of the Navy Medical Corps, said in a statement that the essay is a crucial part as it demonstrates the need to “clearly communicate the findings from our process improvement projects so that others can adopt them.”

He said that while charts and graphs are important, “if we can’t turn it into a narrative, provide a cogent description of the ‘why’ and how we got there, those charts and graphs aren’t going to get us anywhere.”