Facilitating process changes in meal delivery and radiological testing to improve inpatient insulin timing using six sigma method.
BACKGROUND
The objective of this project was to improve the timing of inpatient insulin administration related to meal delivery and the scheduling of radiology tests by Lean Six Sigma method.


METHODS
A multidisciplinary hospital team and a Six Sigma team from a pharmaceutical manufacturer collaborated to evaluate food delivery and radiology scheduling processes related to the timing of insulin administration. Key factors leading to problems within each system were addressed to improve the efficiency of each process while improving the timeliness of glucose testing and insulin administration.


RESULTS
Standardizing the food delivery schedule and utilizing scorecards to track on-time meal deliveries to the floor enabled nursing to more accurately administer insulin in coordination with the delivery of meals. Increasing communication and restricting the scheduling of inpatient procedures during mealtimes reduced disruptions to insulin administration. Data at 6 months postimplementation demonstrated that the institution met goals for most primary outcome metrics including increasing on-time meal delivery and the proportion of patients taking insulin scheduled for radiology tests during appropriate times.


CONCLUSIONS
By implementing the recommendations identified via Lean Six Sigma, this collaborative effort improved the timing of inpatient insulin administration related to meal delivery and radiology testing.
Yamamoto
J Jay
JJ
Eli Lilly and Company, Indianapolis, Indiana 46285, USA. yamamoto_jonathan_jay@lilly.com
Malatestinic
Bill
B
Lehman
Angela
A
Juneja
Rattan
R
D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004435:Eating; D017598:Efficiency, Organizational; D005521:Food Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007297:Inpatients; D007328:Insulin / Q000008:administration & dosage*; D010865:Pilot Projects; D017064:Process Assessment, Health Care; D011872:Radiology Department, Hospital / Q000458:organization & administration*; D015203:Reproducibility of Results; D013997:Time Factors; D017749:Total Quality Management
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin