Abstract

Abstract Introduction A lean six-sigma (LSS) approach to clinical redesign looks at aspects of patient flow, value to consumer and any areas that may be considered wasted time. This LSS approach was used to find areas of improvement in a tertiary care hospital for patients on non-invasive ventilation. The solution developed was to implement a remote download service. Methods Root cause analysis, current state process and effects analysis, staff surveys and time and motion work sampling studies were conducted. There was a post implementation time and motion work sampling study for the remote download service introduced in 2023. Results Motion, transportation, inventory and waiting time and reporting software were found to impact workflow. Time efficiencies were found for non-invasive ventilation download reports with a mean time of 14.8 mins (std 6.7min) pre-implementation down to 2.5 mins (std 0.6min) with remote software. There was an additional time saving due to batch processing prior to clinics of 2.5 mins (std 0.4mins) per patient. Staff reported workload capacity and documentation as two key barriers to effective processes. Discussion LSS identified areas to improve value and flow for staff in sleep clinics and patients on non-invasive ventilation.

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