Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Using Lean Six Sigma to Improve Controlled Drug Processes and Release Nursing Time

Creed, Maria, MSc; McGuirk, Michelle, MSc; Buckley, Ruth, MA; De Brún, Aoife, PhD; Kilduff, Marie, MSc

doi: 10.1097/NCQ.0000000000000364

Background: Hospital controlled drug processes are established to adhere to legislation, with little consideration of efficiency of processes.

Local Problem: A controlled drug process existed, where nurses requested a porter to collect a hand-written order; however, only 19% of drug orders were processed this way. Instead, an unscheduled, ad hoc process led to an average of 17 nurse journeys to pharmacy daily. We aimed to reduce nurse journeys to the pharmacy by 25% to release nursing time.

Methods: A pre-/postintervention design was used with Lean Six Sigma methods.

Interventions: A multifaceted intervention involved process redesign, increasing the frequency of a porter-led delivery service, amending delivery times to reflect times of greatest need, and streamlining checking requirements.

Results: Following implementation, there was a statistically significant 44% decrease in nurse journeys to pharmacy for drug collections, which was maintained after 18 months.

Conclusions: Interprofessional collaboration improving hospital-wide processes can have significant benefits for the release of nursing time.

Pharmacy Department (Ms Creed), Transformation Office (Ms McGuirk), and Quality and Patient Safety Department (Ms Buckley), Mater Misericordiae University Hospital, Dublin, Ireland; School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland (Dr De Brún); National Leadership and Innovation Centre for Nursing and Midwifery, Office of the Nursing and Midwifery Services Director, Health Service Executive, Dublin, Ireland (Ms Kilduff).

Correspondence: Maria Creed, MSc, Pharmacy Department, Mater Misericordiae University Hospital, Eccles St, Dublin, Ireland (

The authors thank the Mater Lean Academy for their support of this research.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

The authors declare no conflict of interest.

Accepted for publication: August 2, 2018

Published ahead of print: September 6, 2018

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved