Integration of a Lean Daily Management System into an Antimicrobial Stewardship Program.

Creator(s)

Ann L. Wirtz, Children's Mercy HospitalFollow
Elizabeth Monsees, Children's Mercy HospitalFollow
Kate Gibbs, Children's Mercy HospitalFollow
Angela Myers, Children's Mercy HospitalFollow
Alaina N. Burns, Children's Mercy Kansas CityFollow
Brian R. Lee, Children's Mercy HospitalFollow
Rana El Feghaly, Children's Mercy HospitalFollow
Gina Weddle, Children's Mercy HospitalFollow
James C. Day, Children's Mercy Hospital
Amol V. Purandare, Children's Mercy HospitalFollow
Jennifer Goldman, Children's Mercy Kansas CityFollow

Document Type

Article

Publication Date

3-10-2021

Identifier

DOI: 10.1097/pq9.0000000000000384; PMCID: PMC7952113

Abstract

Growing demands and limited guidance on efficient use of resources to advance stewardship initiatives challenge antimicrobial stewardship programs (ASP).

Methods: The primary aim was to incorporate a Lean Readiness and Metrics Board (RMB) into ASP and assess team member accountability and satisfaction with weekly 15-minute huddle participation within 1 year of implementation. ASP team survey data were analyzed for comments regarding Lean integration, team communication, and productivity. The second aim was to develop 5 shared metrics associated with quality, people, delivery, safety, and stewardship and evaluate ASP team productivity by assessing the impact of projects targeted at each specific metric. Pharmacist-physician ASP scheduling conflicts were addressed through identified rounding times under the "People" metric. The "Quality" metric assessed ASP intervention disagreement rate and collaborations that occurred to reduce disagreement. ASP tracked the number of individuals educated by ASP monthly through the "Delivery" metric.

Results: Since August 2018, ASP replaced hour-long monthly meetings with weekly huddles at the RMB. On average, 14 members (88%) of the ASP participate weekly. Team members report improvement in communication and satisfaction with Lean integration. Metric utilization enhanced productivity. For the metrics under "People," "Quality," and "Delivery," reduced scheduling conflicts occurred, the ASP intervention disagreement rate decreased (37.0%-25.6%; P < 0.001), and the ASP educated an average of 79 learners per month.

Conclusions: Weekly huddles at the RMB enhanced communication and team accountability while visually displaying program needs, progress, and achievements. The RMB helps to ensure ongoing institutional commitment, and Lean methods show promise for evaluating and improving ASP productivity.

Journal Title

Pediatr Qual Saf

Volume

6

Issue

2

First Page

384

Last Page

384

Recommended Citation

Wirtz AL, Monsees EA, Gibbs KA, et al. Integration of a Lean Daily Management System into an Antimicrobial Stewardship Program. Pediatr Qual Saf. 2021;6(2):e384. Published 2021 Mar 10. doi:10.1097/pq9.0000000000000384