Lean six sigma to reduce pharmacy medication errors in Thai hospitals : an action research study
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Hospital medication errors are costly and contribute to patient mortality, morbidity and decreased health care quality. Although healthcare organizations have endeavoured to reduce medication errors by using several approaches, the errors remained, returned or could not be resolved. The use of CI methodologies, such as Lean Six Sigma, can enable healthcare practitioners to ascertain the problems in the medication process and identify and eliminate the root cause of such problems. However, the existing literature does not address the need for an LSS roadmap in reducing medication errors; therefore, healthcare practitioners do not have an LSS roadmap to follow to reduce medication errors. This study aims to develop an LSS implementation and sustainability roadmap that can guide healthcare practitioners in the implementation of LSS to reduce medication errors. A systematic review was conducted to understand the benefits, challenges, and success factors of LSS implementation in reducing medication errors in a global context. The action research methodology was used to illustrate the employment of Lean Six Sigma through collaboration between the researcher and participants in an inpatient pharmacy of two public hospitals in Thailand. This study was carried out through action research based on the following key phases: identification of problems, reflection, planning action, taking action, evaluation, reflection and specify lessons learnt. The key finding of the systematic literature review revealed that Lean Six Sigma can be very useful on reducing medication errros in a hospital setting and improving patient care. The action research findings clearly show that Lean Six Sigma application improved the inpatient pharmacy dispensing process and contributed to reduced dispensing errors and enhanced patient safety. This is the first study that has developed an LSS roadmap which healthcare practitioners can follow to reduce medication errors using, LSS methodology and, and to sustain LSS in their organizations. This study provides a greater awareness for senior managers and medical directors in hospitals about the role of LSS and its associated tools and techniques in tackling medication errors. Future research can apply the roadmap in other hospitals to ensure its practical validity and enhance the application of LSS in the healthcare setting.