“Understanding LEAN Sigma & Impact on Efficiency”

"Roundtable Discussions"

“Modern Concepts for Inpatient Glucose Control”

The 2010 fall meeting and Vendor Fair was held at the Doubletree Hotel in Alsip, Illinois on Wednesday, October 6 from 9:00 AM to 3:30 PM. 


The meeting was attended by 49 registered healthcare professionals and sponsored by MAS and Abbott.  The Vendor Roster included representatives from Abaxis, Abbott Diabetes Care, Abbott i-Stat , Alere, Axis-Shield, BD, Beckman Coulter, Fisher Healthcare, Helena, Hemocue, Instrumentation Laboratories, ITC, Laboratory Data Systems, Masimo, Nova Biomedical, MAS, Quidel, Radiometer, Roche, Siemens, Telcor and Thermo-Fisher.


The meeting commenced with opening remarks by Joanne McEldowney, RN.  Members of the core group include:  Wendy Denk, Ingalls Hospital, Harvey, IL; Joanne McEldowney, RN, Univ of Illinois – Chicago, Chicago, IL; Gil Salas, Univ of Illinois – Chicago, Chicago, IL and Sandra Curran, Univ of Illinois.    

The first session, Understanding LEAN Sigma & Impact on Efficiency”, was presented by Paul Cantrell, Department of Pathology, UIMC, Six Sigma Green-Belt and was sponsored by MAS.   This introduction to some fundamental basics of LEAN and 6 Sigma started with WHFM, which translates to “What’s In It For Me?” and definitions of Sigma, 6 Sigma and LEAN.  For the uninitiated, Sigma is a term used to represent standard deviation, an indicator of the degree of variation in a set of measurements or a process.  6 Sigma is a statistical concept that measures a process in terms of defects – at the 6 Sigma level, there are only 3.4 DPMO (defects per million opportunities).  6 Sigma is also a philosophy of managing that focuses on eliminating defects through practices that emphasize understanding, measuring and improving processes.  As for LEAN (and who hasn’t been striving for LEAN recently?) is an operational strategy oriented toward achieving the shortest possible cycle time by eliminating waste.


Imagine three shifts, each doing their own thing.  By performing in this method, the risk for error is increased, whereas, everyone following the same protocol, procedure, process, etc. reduces the risk of error and increases productivity.  As for multitasking? The process of multitasking is the ability of being able to screw up more things at the same time.  Sigma and LEAN have been successfully used by many companies and it is now time for healthcare to overcome the barriers of “common errors’’ and make the commitment of “Virtual Perfection”.   Healthcare can’t continue to be average but needs to adopt the same strategy principles (6 Sigma) that were utilized by Toyota, Amazon.com, Pepsi, Quest (to name a few) to become great.  And how can 6 Sigma and LEAN tools help the POCT group? They help identify, quantify and verify root causes; they can identify customer Critical to Quality (CTQs = the I want to needs); maximize efficiencies and effectiveness in processes; reduce variation through standardization; identify and differentiate between non-value added steps and value added steps; provide effective problem resolution; and substantiate requests for resources with quantifiable data.  So, the next time you have 2 analyzers doing the work of 4 analyzers, use LEAN and 6 Sigma means (proactive systems to gather information,  not reactive systems) to evaluate the process, quantify your data, and present this data (use flow charts, spaghetti charts, Fish Charts, etc) to administration for additional equipment.

The Tri-State POC Network thank the vendors in attendance for their representation and support of the October Vendor Fair.

Following the Vendor Fair and lunch, Sandra Curran led the Roundtable Discussions. Her questions to the group were:

  • How are POCC’s addressing the 6 required measures of competency for the ACT test?

  • Does anyone have a diabetes task force in place that focuses on data collection of hyperglycemic events for purposes of finding approaches to minimize these events?

  • Is anyone cleaning the meters after every use and if so, how is it being done?

  • Has anyone changed work processes or made efforts to accommodate the changing economy?

The final presentation, Modern Concepts for Inpatient Glucose Control” was led by David Baldwin, MD, Director of Endocrinology, Rush Medical Center and sponsored by Abbott.  Dr. Baldwin presented these facts: in the 1990s, hospital discharge forms listing diabetes as diagnosis was >50%, in 2002, diabetes accounted for >4.9 million hospital admissions at a cost of $40 billion, yet, inpatient hyperglycemia treatment is sub-optimal in many hospitals. Hyperglycemia is linked to Mortality regardless of Diabetes status and is a common co-morbidity in medical-surgical hospitalized patients.  The length of stay is generally higher for the new hyperglycemia than for normoglycemic or known diabetic, the new hyperglycemic is more likely to require ICU and to need transitional care after discharge, and they trend toward a higher rate of infections and neurologic events.  Rush has eliminated the usual method of treating glycemia (The Sliding Scale) and have established an Inpatient Diabetes Management team to provide a continuity of care from ICU to general floor to rehabilitation to discharge as well as utilize an Insulin Protocol in the Emergency Department.

The next meeting will be in April 13, 2011 at the Doubletree Hotel in Alsip.


Respectfully Submitted,

Wendy Denk, MT(ASCP)

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