Six Sigma process reduces need for continuous 1:1 staffing

Using Six Sigma process improvement methodologies, nurses managers and other researchers at the Hospital of the University of Pennsylvania in Philadelphia developed a protocol for reducing continuous patient observations for nonsuicidal patients. The team implemented a standardized weaning process, which used a behavior observation-tracking tool every four hours to validate the continued need for 1:1 coverage. The pilot occurred across six units over a 12-month period, reducing average monthly 1:1 staffing hours by 25.6% without an increase in adverse safety events. The decrease in continuous observation yielded cost roughly $142,000 in cost savings. The researchers, whose study appeared in the September issue of the Journal of Nursing Administration, have received approval for integrating the observation-tracking tool and reassessment protocol into the hospital’s electronic health record.