Lean Six Sigma as a Management Tool Helps Standardize Antimicrobial Use in Hospital Settings

Qian Wang, Xinru Han, Xiang Zhang, Lubo Guo Department of Pharmacy, Central Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, 250013, People’s Republic of ChinaCorrespondence: Lubo Guo, Department of Pharmacy, Central Hospital Affiliated to Shandong First Medical University, No. 105, Jiefang Road, Lixia District, Jinan City, Shandong Province, 250013, People’s Republic of China, Email [email protected]: This study aimed to standardize antimicrobial use in a hospital setting by implementing the Lean Six Sigma (LSS)-DMAIC model (Define, Measure, Analyze, Improve, Control), addressing the irrational use of antibacterial drugs.Methods: A retrospective analysis was conducted using data from a single hospital’s information system in Shandong, China, covering antibacterial drug usage from January 2020 to December 2021. The LSS-DMAIC framework was applied, which involved defining problems, measuring key indicators, analyzing causes of irrational use, implementing improvement measures, and controlling outcomes. The project team comprised clinical pharmacists and healthcare professionals who evaluated antibiotic use and compliance with guidelines.Results: In the whole hospital, the management through LSS-DMAIC led to a significant reduction in the non-standard utilization rate of antibacterial drugs from 32.5% to 11.3% (P < 0.0001), achieving the set target. The intensity of antibacterial drug use decreased to 38.82 Defined Daily Doses (DDDs), meeting national standards. Additionally, the utilization rate of antibacterial drugs has dropped from 43.61% to 40.16% (P < 0.0001), and the average cost of antibacterial drugs per inpatient significantly dropped from 1909.59 RMB (known as Renminbi, which is the legal currency of China) to 1675.20 RMB (P < 0.0001), resulting in substantial annual savings.Conclusion: The application of the LSS-DMAIC model effectively improved the rational use of antibacterial drugs in the hospital, demonstrating its potential as a valuable management tool in healthcare settings. Continued efforts are necessary to sustain these improvements and further enhance clinician adherence to antimicrobial stewardship practices.Keywords: lean management, six sigma, DMAIC, antibacterial use intensity, quality management