Johnson Amber E, Winner Laura, Simmons Tanya, Eid Shaker M, Hody Robert, Sampedro Angel, Augustine Sharon, Sylvester Carol, Parakh Kapil
Johns Hopkins University School of Medicine, Baltimore, MD.
Armstrong Institute for Patient Safety and Quality, Baltimore, MD.
Am J Med Qual. 2016 May;31(3):272-8. doi: 10.1177/1062860614562627. Epub 2014 Dec 15.
Heart failure (HF) patients have high 30-day readmission rates with high costs and poor quality of life. This study investigated the impact of a framework blending Lean Sigma, design thinking, and Lean Startup on 30-day all-cause readmissions among HF patients. This was a prospective study in an academic hospital in Baltimore, Maryland. Thirty-day all-cause readmission was assessed using the hospital's electronic medical record. The baseline readmission rate for HF was 28.4% in 2010 with 690 discharges. The framework was developed and interventions implemented in the second half of 2011. The impact of the interventions was evaluated through 2012. The rate declined to 18.9% among 703 discharges (P < .01). There was no significant change for non-HF readmissions. This study concluded that methodologies from technology and manufacturing companies can reduce 30-day readmissions in HF, demonstrating the potential of this innovations framework to improve chronic disease care.
心力衰竭（HF）患者30天再入院率高，成本高昂且生活质量差。本研究调查了融合精益西格玛、设计思维和精益创业的框架对HF患者30天全因再入院的影响。这是在马里兰州巴尔的摩一家学术医院进行的一项前瞻性研究。使用医院的电子病历评估30天全因再入院情况。2010年HF的基线再入院率为28.4%，出院690例。该框架于2011年下半年制定并实施干预措施。通过2012年评估干预措施的影响。在703例出院患者中，该比率降至18.9%（P < 0.01）。非HF再入院情况无显著变化。本研究得出结论，技术和制造公司的方法可以降低HF患者的30天再入院率，证明了这一创新框架改善慢性病护理的潜力。
