Case studies where QI, LSS and HFE were used to address a problem
| Problem to be addressed | Why this approach was chosen to address the problem | What was the outcome | Title of cases study and reference | |
|---|---|---|---|---|
| QI | Rapidly improve personal protective equipment (PPE) training during the Covid-19 pandemic | Rapid learning cycles using plan-do-study-act (PDSA) cycles were used to design improvement solutions during the height of the Covid-19 crisis. Frontline staff were enabled to conduct small experiments that were safe but which yielded learning quickly to improve care (as defined by the domains) | In an East London trust in one day, the steps and decisions to procure PPE were mapped by staff, who identified a number of steps that required clarification or could be removed. A digital form was created, aligning with the new standard process, tested by one team, and then scaled throughout the organisation | Fitzsimons, J. (2021) Quality and safety in the time of Coronavirus: design better, learn faster. International Journal for Quality in Health Care, Volume 33, Issue 1, 2021, mzaa051, https://doi.org/10.1093/intqhc/mzaa051 Shah, A., Pereira, P., and Tuma, P. (2021). Quality improvement at times of crisis. BMJ (Clinical research ed.), 373, n928. https://doi.org/10.1136/bmj.n928 |
| Person-centred Lean Six Sigma | The dermatology department faced significant challenges related to excessive outpatient waiting times. There were 3,736 patients awaiting appointments, and 1,615 patients experienced wait times exceeding 12 months. A diverse interdisciplinary team sought to address these issues while also fostering a cultural shift within the working environment to support sustainable improvements | To redesign referral, triage, and scheduling processes, a combination of Lean techniques aimed at minimising non-value-added activities and Six Sigma methodologies focused on reducing process variation was employed. To complement these technical improvements, a person-centred approach was integrated to drive the cultural transformation necessary for sustained change and engagement across the workforce | The initiative led to the establishment of a centralised triage system, enabling a more efficient allocation of appointments and improved management of urgent cases. Post-implementation data indicated a 40% reduction in the overall waiting list and a 60% decrease in the number of patients waiting over 12 months. The intervention significantly reduced waiting times across all urgency categories, with the most pronounced improvements observed in soon and urgent referrals. Furthermore, these changes served as the foundation for a subsequent design-led innovation phase, in which the team collaborated with academic and healthcare partners to facilitate disruptive, system-wide change | Implementing Person-Centred Lean Six Sigma to Transform Dermatology Waiting Lists: A Case Study from a Major Teaching Hospital in Dublin, Ireland Igoe, A., Teeling, S. P., McFeely, O., McGuirk, M., Manning, S., Kelly, V., Coetzee, H., Cunningham, Ú., Connolly, K., and Lenane, P. (2024). Sci, 6(4), 72. https://doi.org/10.3390/sci6040072 |
| HFE | Healthcare acquired infection (HCAI) is a problem globally. A large acute hospital wanted to improve their risk management programme for the prevention and control of HCAI (PCHCAI) | PCHCAI in an acute hospital setting is a complex activity involving multiple stakeholders working across many departments of the meso system of the organisation (e.g. microbiology, occupational health, facilities management) intersecting with many different processes (e.g. screening of patients and healthcare professionals; adherence to evidence based care bundles). Any solution would need to be built on a thorough understanding of this complexity. A HFE STSA analysis was the recommended approach to understand the complexity and where to intervene to gain most leverage for improvement | In carrying out the HFE STSA of the PCHCAI system in the hospital the area of “information and knowledge” emerged as the most relevant area to gain leverage on change and improvement. A large amount of data was gathered across the hospital in relation to PCHCAI activities A deeper exploration of the governance of data, the value of different data sources and adding additional value to them through combining quality and safety data with operational data, big data analytics and machine learning, enabled the translation of all this data into knowledge for proactive risk management. This led to the risk identification, mitigation and management of one HCAI, in an acute ward with higher-than-expected incidence | A systems approach to managing the risk of healthcare acquired infection in an acute hospital setting supported by Human Factors Ergonomics, data science, data governance and AI. Ward, M. E., Geary, U., Brennan, R., Vining, R., McKenna, L., O’Connell, B., Bergin, C., Byrne, D., Creagh, D., Fogarty, M., Healy, U., McDonald, G., Ebiele, M., Crane, M., Pham, M. K., Bendechache, M., Bezbradica, M., Liang, J., Doyle, B., Guilfoyle, J., … McDonald, N. (2024). Ergonomics, 1–19. https://doi.org/10.1080/00140139.2024.2396527 |
| Problem to be addressed | Why this approach was chosen to address the problem | What was the outcome | Title of cases study and reference | |
|---|---|---|---|---|
| QI | Rapidly improve personal protective equipment (PPE) training during the Covid-19 pandemic | Rapid learning cycles using plan-do-study-act (PDSA) cycles were used to design improvement solutions during the height of the Covid-19 crisis. Frontline staff were enabled to conduct small experiments that were safe but which yielded learning quickly to improve care (as defined by the domains) | In an East London trust in one day, the steps and decisions to procure PPE were mapped by staff, who identified a number of steps that required clarification or could be removed. A digital form was created, aligning with the new standard process, tested by one team, and then scaled throughout the organisation | Fitzsimons, J. (2021) Quality and safety in the time of Coronavirus: design better, learn faster. International Journal for Quality in Health Care, Volume 33, Issue 1, 2021, mzaa051, |
| Person-centred Lean Six Sigma | The dermatology department faced significant challenges related to excessive outpatient waiting times. There were 3,736 patients awaiting appointments, and 1,615 patients experienced wait times exceeding 12 months. A diverse interdisciplinary team sought to address these issues while also fostering a cultural shift within the working environment to support sustainable improvements | To redesign referral, triage, and scheduling processes, a combination of Lean techniques aimed at minimising non-value-added activities and Six Sigma methodologies focused on reducing process variation was employed. To complement these technical improvements, a person-centred approach was integrated to drive the cultural transformation necessary for sustained change and engagement across the workforce | The initiative led to the establishment of a centralised triage system, enabling a more efficient allocation of appointments and improved management of urgent cases. Post-implementation data indicated a 40% reduction in the overall waiting list and a 60% decrease in the number of patients waiting over 12 months. The intervention significantly reduced waiting times across all urgency categories, with the most pronounced improvements observed in soon and urgent referrals. Furthermore, these changes served as the foundation for a subsequent design-led innovation phase, in which the team collaborated with academic and healthcare partners to facilitate disruptive, system-wide change | Implementing Person-Centred Lean Six Sigma to Transform Dermatology Waiting Lists: A Case Study from a Major Teaching Hospital in Dublin, Ireland |
| HFE | Healthcare acquired infection (HCAI) is a problem globally. A large acute hospital wanted to improve their risk management programme for the prevention and control of HCAI (PCHCAI) | PCHCAI in an acute hospital setting is a complex activity involving multiple stakeholders working across many departments of the meso system of the organisation (e.g. microbiology, occupational health, facilities management) intersecting with many different processes (e.g. screening of patients and healthcare professionals; adherence to evidence based care bundles). Any solution would need to be built on a thorough understanding of this complexity. A HFE STSA analysis was the recommended approach to understand the complexity and where to intervene to gain most leverage for improvement | In carrying out the HFE STSA of the PCHCAI system in the hospital the area of “information and knowledge” emerged as the most relevant area to gain leverage on change and improvement. A large amount of data was gathered across the hospital in relation to PCHCAI activities | A systems approach to managing the risk of healthcare acquired infection in an acute hospital setting supported by Human Factors Ergonomics, data science, data governance and AI. |
Sharing content requires targeting cookies to be enabled. Please update your cookie preferences to use this feature.