Supply and Demand: Application of Lean Six Sigma methods to improve drug round efficiency and release nursing time

Objective: To improve efficiency, reduce interruptions and reduce time taken to complete, and variability of, oral drug rounds during to release nurse time. Design: Lean Six Sigma methods were applied to improve drug round efficiency using a pre-post intervention design. Setting: A 20-bed orthopaedic ward in a large teaching hospital in Ireland. Participants: Pharmacy, nursing and quality improvement staff. Intervention(s): A multifaceted intervention was designed which included changes in processes related to drug trolley organisation and drug supply planning. A communications campaign aimed at reducing interruptions during nurse-led during rounds was also developed and implemented. Main Outcome Measure(s): Average number of interruptions, average drug round time and variation in time taken to complete drug round. Results: At baseline, the oral drug round took an average of 125 minutes. Following application of Lean Six Sigma methods, the average drug round time decreased by 51 minutes. The average number of interruptions per drug round was an average of 12 at baseline to 11 following intervention, with a 75% reduction in drug supply interruptions. Conclusions: Lean Six Sigma methodology was successfully employed to reduce interruptions and to reduce time taken to complete the oral drug round. This improvement was also sustained following re-location and re-design of the ward configuration.