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Cited by 78Infection Control in HealthcareHealthcare Quality and ManagementNosocomial Infections in ICU

Reducing the risk of healthcare-associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy)

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Improta, Giovanni, Cesarelli, Mario, Montuori, Paolo, Santillo, Liberatina Carmela, Triassi, Maria·2018·Journal of Evaluation in Clinical Practice
DOI 10.1111/jep.12844PMC PMC5900966
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Abstract

Rationale, aims, and objectives: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare‐associated infections (HAIs), a critical quality parameter in the healthcare sector. Methods: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016. Following the LSS define, measure, analyse, improve, and control cycle, the factors influencing the risk of HAI were identified by using typical LSS tools (statistical analyses, brainstorming sessions, and cause‐effect diagrams). Finally, corrective measures to prevent HAIs were implemented and monitored for 1 year after implementation. Results: Lean Six Sigma proved to be a useful tool for identifying variables affecting the risk of HAIs and implementing corrective actions to improve the performance of the care process. A reduction in the number of patients colonized by sentinel bacteria was achieved after the improvement phase. Conclusions: The implementation of an LSS approach could significantly decrease the percentage of patients with HAIs.

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  • Organizational and cultural changes result in direct impacts on clinical aspect of patients, such as infections rate reduction and shorter treatment time.

    “Organizational and cultural changes result in direct impacts on clinical aspect of patients. For this matter, we can highlight, for instance, effects such as “infections rate reduction” and “shorter treatment time” [31,55,63].”

    From Lean Healthcare Tools for Processes Evaluation: An Integrative Review. (2021) · cites this paper as [63]

    The Results report that, after process improvements, the percentage of patients colonized by sentinel bacteria and their duration of hospitalization decreased. The Methods identify colonization as a measure of infection risk, not the infection rate itself; the paper reports shorter hospital stays, not shorter treatment time. Page numbers are unavailable in our copy. (LLM, conf=0.86)

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  • Perspectives on brain-targeting drug delivery systems.

    Guo, L., Ren, J., & Jiang, X. (2012) · Current Pharmaceutical Biotechnology · doi:10.2174/138920112803341770 · Cited by 57 · cited 2× · see citing works

    “That is, they are expected to have both technical and managerial competences.(46,47) We recently applied LSS to reducing the number of patients affected by sentinel bacterial in surgery departments,(48) which resulted in a significant reduction in both the number of hospitalization days and the number of patients with…”
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Authors
Improta, G., Cesarelli, M., Montuori, P., Santillo, L. C., & Triassi, M.
Affiliations
University of Naples Federico II (IT)
Corresponding author
Improta, Giovanni
ORCID
Venue
Journal of Evaluation in Clinical Practice
Publisher
Wiley
Published
2017-11-03
Volume
24
Issue
2
Pages
338-346
ISSN
  • 1356-1294 (ISSN-L)
  • 1365-2753
DOI
10.1111/jep.12844
PMC
PMC5900966
OpenAlex
W2766398381
Cited by
78
References
1
Citations by year
2026: 2 · 2025: 10 · 2024: 3 · 2023: 6 · 2022: 7 · 2021: 22 · 2020: 16 · 2019: 8 · 2018: 4
FWCI
5.89
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Evaluation in Clinical Practice (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Keywords
nosocomial infections, Lean Six Sigma, infection control, quality improvement, infection risk factors
MeSH terms
Cross Infection, Data Collection, Hospitals, University, Humans, Italy, Practice Guidelines as Topic, Efficiency, Organizational, Total Quality Management, Quality Improvement, Root Cause Analysis

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