NUR 630 CLC – Quality Models • Online Nursing Essays

Sample Answer for NUR 630 CLC – Quality Models Included After Question

This is a Collaborative Learning Community (CLC) assignment.

The purpose of this assignment is to examine quality models used in health care. With your CLC group, create a 12-15 slide PowerPoint on Lean, Six Sigma, and 5S quality models. Include the following in your presentation:

A description of each quality model.
A brief history of each quality model.
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A description and examples of how each quality model can be applied to the health care setting.
Include a title slide, references slide, and comprehensive speaker notes.
Use a minimum of four peer-reviewed, scholarly references as evidence.
Refer to the resource, “Creating Efective PowerPoint Presentations,” located in the Student Success Center, for
additional guidance on completing this assignment in the appropriate style.
While APA style is not required for the body of this assignment, solid academic writing is expected, and
documentation of sources should be presented using APA formatting guidelines, which can be found in the
APA Style Guide, located in the Student Success Center.
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A Sample Answer For the Assignment: NUR 630 CLC – Quality Models

Title:  NUR 630 CLC – Quality Models

Objectives 

 Welcome to our presentation on quality models. Its purpose is to examine the quality models used in health care to understand better the principles and procedures guiding quality improvement in health care. This presentation explores three quality models: Lean, Six Sigma, and 5S quality models. A brief history of each model is provided to understand them better, including how they are applied in other practices besides health care. The other important part is explaining how each quality model can be applied to the health care setting. The explanation will also provide examples of how the Lean, Six Sigma, and 5s quality models can be used in quality improvement.

Lean Quality Model   

Lean principles in the healthcare system imply observing ways valuable healthcare processes are and drilling into that process to see if waste for patients can be eliminated. Healthcare processes are ever-changing, thus the need to observe the key process that delivers value to patients. The Lean model offers a structural way to eliminate waste and waits and increase patient value. It emphasizes the contemplation over staff involvement, patient needs, and continuous improvement (Lawal et al., 2014). Therefore, the lean model is a model that is applied to healthcare to ensure continuous improvement. 

Enhanced customer value (patient and payer), waste elimination, and operations optimization are key focuses of a lean healthcare organization. In addition, it builds a culture that embraces respect for all staff, the provision of opportunities for daily work improvement, and the exchange of ideas for continuous improvement (Lawal et al., 2014). Lean thinking is linked to better work processes, reduced errors, and defects, reduced costs, better flow of processes, simplified processes, enhanced employee morale, and decreased lead time.

Healthcare organizations, especially in the United States, are increasingly applying lean ideas in healthcare to minimize waste with continuous process improvement. They learn ways to apply lean ideas to improve patient satisfaction and care outcomes at reduced costs. The application of lean ideas in health facilities offers an effective way for waste minimization in all procedures, processes, and tasks through continually improving systems.

In addition, it allows all staff, including clinicians, administration staff, operations staff and other health professionals to make every effort to establish areas generating waste, and get rid of all things that do not add to patient value. Patients and payer satisfaction is a key focus in applying lean principles in healthcare. Lean thinking needs members’ buy-in allowing the organization as a team to be successful (Catalyst, 2018). It ensures decisions and processes are more patient-focused.  

Brief History of Lean Model

The lean concept is grounded on efficient operations or manufacturing arising from the Toyota Production System (TPS) in the mid-20th century. Its philosophy derives from the need to achieve customer value and continuous delivery of the desired value by eliminating wasteful resources, which do not contribute to customer value goals. The core of this concept is doing less work while achieving more customer value with zero-waste.

The process initiated by Henry Ford focused on individual worker empowerment to attain maximum potential and make the highest contribution possible. The start of modern manufacturing gave way to the inception of the lean concept. Modern manufacturing is linked to the mass-production system creating large quantities of standardized products first integrated by Henry Ford. By integrating this process, Ford created a flow of production. This process was quick and efficient. Ford fabricated and assembled his vehicles’ components through mass production in a few minutes.

The process thrived between 1908 and 1927 (Dekier, 2012). Later, the major drawback of this method was established as focus on quantity rather than customer value, since it focused more on the amount of production. As a result, Toyota and Taiichi later collaborated and developed an advanced production method with the right-sized machines for the required volume, along with self-monitoring machines to ensure they achieve the desired value by eliminating waste.

This method was established as quicker, cost-effective, and manufactures high-quality products with greater diversity. Ohno encountered the constraint of trading off between productivity and quality (Dekier, 2012). Through his experiments, more novel ideas were created that became recognized as TPS, which is the basis of the lean concept. James Womack, Daniel Roos, and Daniel Jones coined the Lean Manufacturing in 1991. 

Example 1: Elimination of Defects for Quality Improvement and Increased Reimbursement 

Defects Elimination to Improve Quality of Care and Enhance Reimbursement:  In healthcare, some examples of defect waste include misdiagnosis, medical mistakes, and processor system failures. Others include CLABSI infections, medication or surgical errors, preventable allergic reactions, avoidable readmissions, or flawed medical records. Thus, healthcare organizations can apply lean principles to eliminate this defect waste through improved processes and continuous improvement. Improved worker morale and commitment will ensure fewer mistakes and errors, which will lead to improved care quality and decreased costs. In addition, payers are shifting towards paying for performance models that penalize/reward outcomes (Catalyst, 2018). Hence, healthcare organizations can apply lean principles to mobilize every worker to eliminate defect waste and ensure a better quality of care for increased reimbursement from payers.  

Example 2:Remove Waste from Over-Processing 

When unnecessary work goes into patient treatment, over-processing occurs. Examples of unnecessary work in healthcare include filling out multiple forms with the same information, unnecessary tests, and entering data into more than one system. Unnecessary effort, resources, and time are eliminated by applying lean principles because they add no quality to the care provided or contribute to better patient outcomes. Lean analysis helps eliminate this kind of waste or transform it into useful resources.

When organization members view all processes through the lens of lean healthcare, they can establish repetitive, redundant, and fewer processes for time and money-saving (Catalyst, 2018). It will allow them to understand how healthcare waste results in untapped human potential. If the above aspects consume workers’ time, they cannot use it to leverage their inventiveness and aptitudes for work that optimizes operations and facilitates improved patient care. Saving waste time, effort, and resources ensures employees put adequate effort, time, and resources for educational pursuits, executing system-based improvements, and building provider-patient relationships linked to a high quality of care. It will foster a lean culture characterized by staff with greater morale and commitment (Catalyst, 2018).

Six Sigma Quality Model 

Six Sigma is a continuous improvement process model that has been widely employed in the health care industry to improve patient safety and satisfaction while reducing costs (Antony et al., 2018). However, because it is a practical, problem-solving tool, it can be applied in other disciplines and settings.  According to Fondahn et al. (2016), Six Sigma aims to improve quality by identifying and eliminating the causes of defects (errors) and reducing variability in processes. To achieve this goal, Six Sigma utilizes a five-step, data-driven process improvement methodology, define, measure, analyze, improve, and control or the acronym DMAIC.

The DMAIC method seeks to improve existing processes by defining the problem or issue for improvement, measuring the performance of the process by collecting relevant data, analyzing the data to determine the root causes of poor performance, improving the process by eradicating the root causes, and controlling improved processes to ensure the better results are sustained (Fondahn et al., 2016). Although there are other quality tools that exist within the Six Sigma methodology, DMAIC is more commonly employed because of its systematic, robust framework (Improta et al., 2019).

Brief History of Six Sigma Model
 

With a focus on enhanced quality and safety, Six Sigma was developed in the late 1980s by Motorola to optimize efficiency, decrease costs, and improve the customer experience by operating at a “six sigma” level (Fondahn et al., 2016).  This means that the company’s goal was to reduce defects to 3.4 for every one million opportunities since defects equates to increase costs (Fondahn et al., 2016). Since its inception, Motorola has saved billions of dollars as a direct result of Six Sigma and its quality tools and techniques (Antony et al., 2018).

Due to its enormous success, other companies such as General Electric (GE) have followed suit and used the concepts and principles in Six Sigma as a core business strategy (Antony et al., 2018). In health care, Antony et al. (2018) indicated that Commonwealth Health Corporation in partnership with GE was the first health care organization to initiate Six Sigma in its radiology department. As a result of this initiative, Commonwealth Health Corporation revenue increased by $1.2 million, radiology throughput improved by 33 percent, and radiology cost per radiology procedure decreased by 21.5 percent (as cited in Antony et al. 2018)).

 Description and Example of How the Six Sigma Model  Applies to the Health Care Setting 

In health care, clinicians function under the philosophy of “first, do no harm”.  Because patient safety is priority, the principles and concepts in Six Sigma are in alignment with the objectives and goals in health care. For example, after a systematic review Antony et al. (2018) identified the benefits of adopting Six Sigma in healthcare such as enhanced patient safety, improvements in processes, and increased revenue. Antony et al. (2018) further noted the importance of ensuring leadership is not only familiar with the concepts and principles in Six Sigma, but that they fully participate and adhere to its quality processes.

Moreover, Improta et al. (2019) revealed the success of a hospital in Italy, A.O.R.N. Cardarelli of Naples, which reduced the pre-operative average length of stay (LOS) for femur fractures from 6.90 to 3.15 days by implementing a diagnostic-therapeutic-assistance clinical pathway (DTAP) using the Six Sigma methodology. Six Sigma has proven to be a reliable tool in achieving positive results in health care by reducing costs and improving quality.

5S Quality Model  

1. This model is used in healthcare to improve performance and has 5 steps to improve organization in the workplace (AHRQ, n.d.). These five steps are: 

Sort- keep the area clean, eliminate clutter, and retain only the necessary items

Straighten- assign locations for everything and ensure it is clearly labeled

Scrub- ensure the workplace is clean and organized at all times

Standarize-maintain that order and cleanliness

Sustain- make the 5S apart of the culture (AHRQ, n.d.)

2. This tool is very easy to use and requires no training (AHRQ, n.d.)

3. This tool would be incorporated in situations where there is a lack of order in the organization (AHRQ, n.d.). The aim of this tool in organizations include to provide the best care to the patient with the most effective way (Shahali et al., 2019). 

4. Advantages include it improves patient confidence in the organization, increases overall productivity, improves safety in the workplace, and can create a less frustrated environment (AHRQ, n.d.). The only disadvantage includes that it can take a significant amount of time to implement (AHRQ, n.d.). 

 Brief History of 5S Model 

The origination of the 5S model was from Japan by a Hiroyuki Hirano (Shahali et al., 2019). It stood for the 5 Japanese words that when translated into English stood for sort, set in order, shine, standardize, and sustain (Shahali et al., 2019).  With the success that Toyota had with the use of the 5S models organizations everywhere began to implement the model as well in their practices (Pimping, 2022). Now the model can be seen utilized in health care, manufacturing, and in retail (Pimping, 2022). 

Description and Examples of How the 5S  Applies to The Health Care Setting 

There are many ways that the 5S model can be used in healthcare today. This model is often referred to the most often used and the simplest model today (Johnson & Sollecito, 2020). 

1. An example of improvement in efficiency in health care can include helping decrease patient waiting times in the office (Johnson & Sollecito, 2020). 

2. Patient centered care- It can help decrease the amount of time spent on other activities that do not involve patient care (Johnson & Sollecito, 2020). 

3. Patient Safety- help with a reduction of surgical site infections, CA-UTI’s or CLABSI’s. 

4. The University of Kansas Healthcare system found that by using the 5S model they were able to reorganize their surgical bays in a way that made the workflow more efficient (AHC MEDIA, 2020). They were able to identify supplies that were not needed and organize supply’s in a way that was easier to get to and find (AHC MEDIA, 2020). 

Conclusion

The goal of this presentation is to provide a high-level overview of three quality models that are used in healthcare – Lean, Six Sigma, and 5S. To provide a better understanding of the principles and purpose of each of the quality models a description and history of each of the models was presented. 

Lean offers a model that drives waste elimination and focuses on value-added improvements to customers. It is grounded in the manufacturing world and arose from the Toyota Production System. 

Six Sigma approaches quality improvement by focusing on patient safety and satisfaction while also reducing costs through application of the DMAIC (Define, Measure, Analyze, Improve, Control) methodology. It is centered on eliminating the cause of defects and reducing process variability (Fondahn, 2016). Six Sigma was developed by Motorola approximately 35 years ago with a goal to improve the customer experience by means of optimization and cost reductions (Fondahn, 2016). 

The 5S model was developed in Japan by Hiroyuki Hirano (Shahali et al., 2019). The quality improvement framework for 5S includes 5 steps: Sort, Straighten, Scrub, Sanitize, and Sustain. This tool requires little training and can lead to increased productivity and safety in the workplace while limiting staff frustrations (AHRQ, n.d.). 

Following the description and history, each of the quality models were explained by their application in the healthcare setting, including examples.

Lean can be used to eliminate defects, enhance reimbursement, and eliminate unnecessary work. Examples would be misdiagnosis, medical mistakes, and over-processing by form duplication.

Six Sigma presents benefits of enhancing patient safety, improving processes, and increasing revenue (Antony et al., 2018). An example would be decreasing patient length of stay by implementing a clinical pathway for pre-operative patients.

The 5S model can improve efficiency by reducing patient waiting times and improve patient care by increasing time spent with patients instead of time searching for supplies or other activities.  

Each of these three quality models are effective when addressing improvement needs in the healthcare setting. They provide staff with options for approaching a particular quality improvement process dependent on the question that needs to be addressed.

Thank you for your time and attention as we presented this learning opportunity on quality models in healthcare

Reference:

AHC MEDIA. (2020). Following Lean and the 5S Philosophy Can Make Quality Improvement Sustainable. Same-Day Surgery, 44(3), N.PAG.

Johnson, J. K., & Sollecito, W. A. (2020). Mclaughlin & kaluzny’s continuous quality improvement in health care (5th ed.). Jones & Bartlett Learning.