Under value-based purchasing, Medicare withholds reimbursements for hospital-acquired pressure ulcer occurrence and rewards hospitals that meet performance standards. With little evidence of a validated prevention process, nurse managers are challenged to find evidence-based interventions.
The aim of this study was to reduce the unit-acquired pressure ulcer (UAPU) rate on targeted intensive care and step-down units by 15% using Lean Six Sigma (LSS) methodology.
An interdisciplinary team designed a pilot program using LSS methodology to test 4 interventions: standardized documentation, equipment monitoring, patient out-of-bed–to–chair monitoring, and a rounding checklist.
During the pilot, the UAPU rate decreased from 4.4% to 2.8%, exceeding the goal of a 15% reduction. The rate remained below the goal through the program control phase at 2.9%, demonstrating a statistically significant reduction after intervention implementation.
The program significantly reduced UAPU rates in high-risk populations. LSS methodologies are a sustainable approach to reducing hospital-acquired conditions that should be broadly tested and implemented.
Author Affiliations: Wound Ostomy Continence Nurse Coordinator (Ms Donovan); Research Assistant (Ms Manta) and Research Associate (Ms Goldsack), Value Institute; and Director of Nursing Development and Education (Ms Collins), Christiana Care Health System, Newark, Delaware.
The authors declare no conflicts of interest.
Correspondence: Ms Goldsack, Value Institute, Christiana Care Health System, 4755 Ogletown-Stanton Rd, Newark, DE 19718 (email@example.com).
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