Lean Six Sigma Reduces Documentation Discrepancies for Bill Only Items in the Operating Room

Utilizing Six Sigma's DMAIC model, this project looked at ways to decrease errors in the documentation of bill-only items in the hospital's main OR. Bill-only items are items not held in the hospital's inventory and are brought in for use by third-party vendors. Due to the lack of a user-friendly electronic documentation process, the main OR was forced to manually reconcile discrepancies related to bill only items. To improve, the project team developed a standardized paper form that acts as a secondary documentation source for the vendor and nursing staff. The new form acts as a backup form of documentation and can be used to correct discrepancies in the medical record more easily. Results of the project showed a 50 percent improvement in documentation discrepancies after go-live. Pre-intervention, the hospital had a 14 percent defect rate in documenting bill only items and after intervention, this error rate decreased to 7 percent.

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)