Quality Improvement Methodologies: Principles and Applications in the Pediatric Emergency Department

Russell Migita; Hiromi Yoshida; Lori Rutman; George A Woodward

doi:10.1016/j.pcl.2018.07.011

Quality Improvement Methodologies: Principles and Applications in the Pediatric Emergency Department

Pediatr Clin North Am. 2018 Dec;65(6):1283-1296. doi: 10.1016/j.pcl.2018.07.011.

Authors

Russell Migita¹, Hiromi Yoshida², Lori Rutman², George A Woodward²

Affiliations

¹ Department of Pediatrics, Division of Emergency Medicine and Emergency Department, Seattle Children's Hospital, University of Washington School of Medicine, MB.7.520, PO Box 5371, Seattle, WA 98145-5005, USA; UW Medicine Center for Scholarship in Patient Care Quality and Safety, UWMC Health Sciences, BB1240, Campus Box #356526, 1959 NE Pacific Street, Seattle, WA 98195, USA. Electronic address: Russ.migita@seattlechildrens.org.
² Department of Pediatrics, Division of Emergency Medicine and Emergency Department, Seattle Children's Hospital, University of Washington School of Medicine, MB.7.520, PO Box 5371, Seattle, WA 98145-5005, USA.

PMID: 30446063
DOI: 10.1016/j.pcl.2018.07.011

Abstract

The origins of quality improvement in health care trace back to industry. Lessons learned from the "flow production" system of the Ford Model-T assembly line in Michigan and the Toyota Production System led to direct applications of Lean and Six Sigma to improve health care systems. Emergency medicine is well suited as a testing and proving ground for quality improvement methodologies because of high patient volume and rapid turnover. This article reviews the history of quality improvement in health care, describes Lean principles in detail, and provides illustrative examples of applications of Lean and quality improvement methodologies in the pediatric emergency department.

Keywords: Emergency medicine; Lean; Pediatrics; Quality improvement.

Publication types

Review

MeSH terms

Child
Emergency Service, Hospital / standards*
Humans
Pediatric Emergency Medicine / standards*
Quality Improvement*
Quality of Health Care / standards*