Applying Lean Six Sigma methodology to reduce cesarean section rate

Chai, Zeying; Hu, Hua-Min; Ren, Xiu-Ling; Zeng, Bao-Jin; Zheng, Lingzhi; Qi, Feng

doi:10.1111/jep.12671

Cited by 12 publications

(9 citation statements)

References 14 publications

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“…Internal processes Clinical indicators Reduction in the rate of mechanical ventilation use, in the rate of care-related infection, in surgical complications, in the fall rate, in the number of cesareans, and improvement in the rate of hand hygiene (3,12,20,(26)(27)(28)(31)(32)37,40) .…”

Section: Bsc Perspective Improvement Results For Health Institutionsmentioning

confidence: 99%

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Lean Six Sigma methodology application in health care settings: an integrative review

2020

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Objective: to analyze the scientific production on the results of Lean Six Sigma methodology in health care institutions. Methods: an integrative literature review, with the following question: what are the results in health institutions using Lean Six Sigma and Six Sigma methodology? The search was carried out at MEDLINE, LILACS, BDENF, CINAHL, Web of Science, and Scopus, with no time frame. Results: thirty-four articles were included, published between 2005 and 2019, of which 52.9% came from the United States of America. The most commonly found improvements were in hospital institutions and from the perspective of customers and internal processes. Conclusion: using Lean Six Sigma methodology proved to be effective in the different health care settings, evidencing a gap in its application regarding people engagement and training.

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Section: Bsc Perspective Improvement Results For Health Institutionsmentioning

confidence: 99%

“…Applying Lean Six Sigma methodology to reduce cesarean section rate (27) 2016 China Use of LSS to reduce the rate of cesarean section in the hospital.…”

Section: Hospitalmentioning

confidence: 99%

Lean Six Sigma methodology application in health care settings: an integrative review

2020

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“…A smaller number of mothers prefer the C-section because it is a safer and healthier method for delivery. According to Chai et al (25), a large number of pregnant women prefer the C-section due to fear of pain. The use of anesthesia in the delivery room can be effective in reducing fear.…”

Section: Managing Insurance and Financial Affairsmentioning

confidence: 99%

“…With the Cervical Dilatation of More Than 4 cm Chai et al (25) stated that inappropriate interventions and inadequate training in labor led to an increase in the C-section rate. Dias et al (64) also showed that the hospitalization of less than 4 cm cervical dilatation and the use of analgesics are some of the midwifery factors leading to an increase in C-section rates.…”

Section: The Policies For Admission and Hospitalization Of Womenmentioning

confidence: 99%

Assessment of Strategies for the Reduction of Cesarean Section Rate in Iranian and Foreign Studies: A Narrative Review

Moghadam

Alijani

Afrakoti

et al. 2020

International Journal of Women’s Health and Reproduction Scienc

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Objectives: This study was conducted aiming at exploring strategies for reducing cesarean section (C-section) in Iranian and foreign studies. Materials and Methods: The present study was carried out using a matrix approach and searching keywords including "Cesarean", "Effective Intervention", and "Cesarean Section Reduction Strategy" to find studies (2000-2019) in databases such as PubMed, SID, Science Direct, Google Scholar, and WHO. Results: CS reduction strategies were classified into 3 categories of psychological, clinical, and structural-policy interventions. The first category supports women throughout labor and childbirth by the midwife, doula, coping skills with fear and pain of labor, changes in the attitudes of service providers and pregnant women. Clinical interventions include vaginal birth after CS, vaginal breech delivery, external cephalic version (ECV) for breech presentation, encouragement of service providers into intermittent auscultation for the fetal heart rate instead of continuous electronic fetal monitoring (EFM), and training of service providers, pregnant woman, and her family. The last category encompassed managing insurance and financial services, receiving one-to-one care and midwifery care throughout active labor, and updating policy of labor induction in post-term pregnancy, as well as women’s admission policy with cervical dilatation of more than 4 cm with regular uterine contractions, active team care in labor, and auditing and feedback. Conclusions: It seems that multi-dimensional interventions are required to reduce the CS rate. Concerning some of the strategies (e.g., ECV), it is suggested that further research should be performed by addressing the limitations and drawbacks of previous studies before applying clinical procedures due to contradictory results.

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“…Six Sigma methodology has been found to reduce the length of hospital stay by minimizing the possible variabilities (9). The rate of cesarean section in pregnancy was reported to decrease from 41.83% to 32% by Six Sigma methodology (10). Moreover, Six Sigma methodology has been used in the nursing care of patients with hip fractures (11).…”

Section: Introductionmentioning

confidence: 99%

Effects of Six Sigma methodology on depression and anxiety of patients with end-stage renal disease

Yang¹,

Wang²,

Cao³

et al. 2021

Ann Palliat Med

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Background: Depression and anxiety are common psychological conditions in end-stage renal disease (ESRD) patients and contribute to poor quality of life and increased mortality. Six Sigma methodology is a novel method of hospital management. The aim of the present study was to determine whether Six Sigma methodology could reduce the incidence of depression and anxiety in ESRD patients. Methods: ESRD patients undergoing hemodialysis from March 2018 to February 2020 were enrolled in the study. They were divided into the control group or study group according to whether they received conventional nursing care or Six Sigma methodology, respectively. Data on patients' demographic characteristics were retrospectively collected. The conditions of depression and anxiety were assessed by the Self-Rating Depression Scale and the Self-Rating Anxiety Scale, and the severity of depression and anxiety was defined according to the scores of the scales. Univariable and multivariable logistic regression analyses were used to determine the risk factors of depression and anxiety at discharge in ESRD patients and the effects of Six Sigma methodology on them. Results: A total of 251 patients were retrospectively enrolled in the study, with 112 patients in the control group and 139 patients in the study group. There were no significant differences in the collected demographic characteristics between the two groups. Six Sigma methodology was shown to relieve mild and moderate depression and anxiety at discharge; however, severe depression and anxiety was hardly affected by Six Sigma methodology. The results from multivariable logistic regression analysis identified Six Sigma methodology as an important protective factor of psychological conditions at discharge. Depression and anxiety status at admission and older age are also independent risk factors for anxiety at discharge in ESRD patients. Marital status may also play a role in the incidence of depression. Conclusions: Six Sigma methodology is significantly useful to reduce the incidence of mild and moderate depression and anxiety at discharge, and should be extended to improve psychological conditions in ESRD patients.

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Applying Lean Six Sigma methodology to reduce cesarean section rate

Abstract: LSS is an effective way to reduce the rate of cesarean section.

Cited by 12 publications

References 14 publications

Lean Six Sigma methodology application in health care settings: an integrative review

Lean Six Sigma methodology application in health care settings: an integrative review

Assessment of Strategies for the Reduction of Cesarean Section Rate in Iranian and Foreign Studies: A Narrative Review

Effects of Six Sigma methodology on depression and anxiety of patients with end-stage renal disease

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