title: [Improving inpatient pharmacoterapeutic process by Lean Six Sigma methodology].
abstract: BACKGROUND
  Lean Six Sigma methodology has been used to improve care processes, eliminate waste, reduce costs, and increase patient satisfaction.
  
  
  OBJECTIVE
  To analyse the results obtained with Lean Six Sigma methodology in the diagnosis and improvement of the inpatient pharmacotherapy process during structural and organisational changes in a tertiary hospital.
  
  
  METHODS
  
  
  
  METHODS
  1.000 beds tertiary hospital.
  
  
  METHODS
  prospective observational study. The define, measure, analyse, improve and control (DMAIC), were deployed from March to September 2011. An Initial Project Charter was updated as results were obtained.
  
  
  METHODS
  131 patients with treatments prescribed within 24h after admission and with 4 drugs.
  
  
  METHODS
  safety indicators (medication errors), and efficiency indicators (complaints and time delays).
  
  
  RESULTS
  Proportion of patients with a medication error was reduced from 61.0% (25/41 patients) to 55.7% (39/70 patients) in four months. Percentage of errors (regarding the opportunities for error) decreased in the different phases of the process: Prescription: from 5.1% (19/372 opportunities) to 3.3% (19/572 opportunities); Preparation: from 2.7% (14/525 opportunities) to 1.3% (11/847 opportunities); and administration: from 4.9% (16/329 opportunities) to 3.0% (13/433 opportunities). Nursing complaints decreased from 10.0% (2119/21038 patients) to 5.7% (1779/31097 patients). The estimated economic impact was 76,800 euros saved.
  
  
  CONCLUSIONS
  An improvement in the pharmacotherapeutic process and a positive economic impact was observed, as well as enhancing patient safety and efficiency of the organization. Standardisation and professional training are future Lean Six Sigma candidate projects.
authors.affiliation: Servicio de Farmacia, Hospital Universitari i Politècnic La Fe, Valencia, España. Electronic address: Font_isa@gva.es.
authors.forename: I
authors.initials: I
authors.lastname: Font Noguera
authors.forename: M J
authors.initials: MJ
authors.lastname: Fernández Megía
authors.forename: A J
authors.initials: AJ
authors.lastname: Ferrer Riquelme
authors.forename: S
authors.initials: S
authors.lastname: Balasch I Parisi
authors.forename: M D
authors.initials: MD
authors.lastname: Edo Solsona
authors.forename: J L
authors.initials: JL
authors.lastname: Poveda Andres
mesh_terms: D004358:Drug Therapy / Q000592:standards*; D004526:Efficiency; D006760:Hospitalization; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control; D011446:Prospective Studies; D058996:Quality Improvement
keywords: Error de medicación; Lean Six Sigma methodology; Medication error; Mejora de la calidad; Metodología Lean Seis Sigma; Patient safety; Quality improvement; Seguridad del paciente