Naval Hospital Bremerton Improves Patient Safety

Douglas H. Stutz
Naval Hospital Bremerton Public Affairs

April 19, 2010 - Naval Hospital Bremerton’s Lean Six Sigma team has recently concluded a Continuous Process Improvement project that incorporated Failure Modes and Effects Analysis (FMEA) to improve the command’s high level disinfection process for ultrasound probes.

It was the first time in Navy Medicine West to combine principles of the Lean Six Sigma program with the FMEA model. The results improve patient safety in the command’s Emergency Department, OB/GYN, Family Medicine and Radiology clinics, and Naval Branch Health Clinic Bangor. “Our main goal was to continue ever improving patient safety to further decrease any potential risk for any bad outcome,” said Lt. Cmdr Wendy Cook, Command Lean Six Sigma Black Belt expert. “Consistent high-level disinfection of the ultrasound probes will ensure proper decontamination of equipment and provide the safest patient care environment.”

Cook attests that high-level disinfection is a complicated process with multiple steps and requirements. Both product (ultrasound probe) manufacturer and disinfection solution manufacturer guidelines must be followed. With such steps as soaking and rinsing, the entire process requires approximately 20 minutes to complete.

“There were concerns with the different areas each doing different steps,” said Cook. “Initially there was some resistance at the clinic level because it seemed counter-intuitive to them to enact the change. But leadership and teamwork made it happen.”

According to Cook, Lean Six Sigma is the Department of the Navy and Navy Medicine's preferred process improvement methodology. “The "Lean" focuses on improving value by reducing waste in a process,” said Cook, explaining that the "Six Sigma" focuses on improving quality by reducing both variation and defects in a process. “The two methods are often combined into "Lean Six Sigma" for a powerful process improvement method that is used throughout [the Navy].”

Cook and the team conducted a health care FMEA to identify failure modes and potential solutions for the high-level disinfection process.

“FMEA is a process improvement technique that involves taking a proactive look at a process to see what things could go wrong in a process [failure modes], rank the severity of the failure modes, and identify ways to prevent the failures,” said Cook.

Cook and the team properly aligned all clinic disinfectant areas by firmly establishing a step-by-step written protocol to follow. “We identified very easy ways to address any potential problem and the recommendations were then implemented,” said Cook.

Cook singled out Hospital Corpsman Second Class Lena Redkina and Hospitalman Apprentice Dylan Nelson of OB/GYN and Hospitalman Kaitlin Wilderman of Family Medicine for their work in implementing the necessary changes.

“They have all been exceptional in learning every detail and helping others,” said Cook, adding that their professionalism has greatly helped the Lean Six Sigma team.

“It makes me feel better knowing that we’re doing all we can to be as safe as possible,” said Rekina. “It can be difficult when we run six clinics because it is a time-consuming process, but we’re doing it the right way and that’s the right thing to do.”

The efforts involved in the project have been recognized in Navy Medicine circles. Capt. Stewart W. Comer, Navy Medicine West Regional Medical Director, Lean Six Sigma Black Belt and trogram manager e-mailed his appreciation to the team: “I wanted to congratulate Naval Hospital Bremerton for their exceptional work on a project that was both a Joint Commission FMEA and a Continuous Process Improvement, Lean Six Sigma Project.”