Lean Six Sigma Reduces Non-Value-Added Amylase Testing by 82% in a Tertiary Medical Center Emergency Department

Studies show lipase to be as sensitive as and more specific than amylase in diagnosing pancreatitis; performing amylase with lipase adds no value over lipase testing alone. Nonetheless, analysis of a tertiary emergency department (with 70,000 visits per year) between January and April 2014 revealed that lipase was ordered with amylase 73.5 percent of the time. This practice adds significant cost to the patient and the payer system, with no added value to patient care.

Studies show lipase to be as sensitive as and more specific than amylase in diagnosing pancreatitis; performing amylase with lipase adds no value over lipase testing alone. Nonetheless, analysis of a tertiary emergency department (with 70,000 visits per year) between January and April 2014 revealed that lipase was ordered with amylase 73.5 percent of the time. This practice adds significant cost to the patient and the payer system, with no added value to patient care.

The project goal was to decrease the use of amylase testing by at least 50 percent using a physician-engaged team within a Lean Six Sigma framework. Results showed that unnecessary amylase testing was reduced by 82 percent as a result of this project, reducing the financial burden to patients and payers while maintaining quality patient care.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations 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—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/