Lean Methodology in the Process of Prescribing and Administering Therapeutics in the Intensive Care Unit

Abstract

A very common problem in Intensive Care Units lies in healthcare provision risks. Intensive care units where there is sophisticated technology. and developed in the Cardiac Intensive Care Unit (CICU) of Hospital in Portugal. The project aimed to detected gaps in the drugs prescription and administration process. Methods: We used the Lean methodology to diagnose the CICU issues, by mapping the process, identifying wastes, monitoring them and defining strategies to eliminate the wastes, with healthcare professionals. Results: We identified wastes in 71.4% of the process, being 60% of them “defects”. Theses wastes were monitored to understand their incidence in the process. Lastly, we identified the root-causes of wastes with the healthcare professionals and possible improvement measures. Conclusions: The wastes of “defect” can easily generate error in the drugs administration process to patients. In root-cause analysis, we detected that every defect were caused by the same main reason – the lack of a system that allows an easy visualization of the updated prescription. This way, two improvement measures were established – a short-term and a long-term improvement measure. The healthcare professionals’ involvement in the improvement project is essential, because they know better the process, and they manage the implementation and sustainability of the improvement measures in the CICU. Their involvement in this type of projects motivates them to actively participate in improvement projects in the hospital.