Treffer: A3 problem solving: Implementing a lean approach to health care quality improvement to decrease central line-associated bloodstream infections.

Title:
A3 problem solving: Implementing a lean approach to health care quality improvement to decrease central line-associated bloodstream infections.
Authors:
Yaglowski J; Jason Yaglowski is an RN Quality Lean Coach at Allegheny Health Network, Allegheny General Hospital in Pittsburgh, PA.
Source:
Nursing [Nursing] 2025 Nov 01; Vol. 55 (11), pp. 57-62. Date of Electronic Publication: 2025 Oct 20.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Lippincott, Williams & Wilkins Country of Publication: United States NLM ID: 7600137 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1538-8689 (Electronic) Linking ISSN: 03604039 NLM ISO Abbreviation: Nursing Subsets: MEDLINE
Imprint Name(s):
Publication: <2002- > : Springhouse, PA : Lippincott, Williams & Wilkins
Original Publication: Jenkintown, Pa., Intermed Communications.
MeSH Terms:
Quality Improvement*/organization & administration , Problem Solving* , Catheter-Related Infections*/prevention & control , Catheterization, Central Venous*/adverse effects , Catheterization, Central Venous*/nursing , Total Quality Management*/organization & administration, Humans ; Trauma Centers/organization & administration
References:
Liker JK. The Toyota Way: 14 Management Principles from the World's Greatest Manufacturer. McGraw Hill Education; 2021.
Deming EW. Out of Crisis. Massachusetts Institute of Technology; 1982.
Graban M. Lean Hospitals. 2nd ed. CRC Press; 2018.
Yaglowski J. Implementing the Lean 5S process improvement to boost efficiency and cost savings in hospital supply rooms. Nursing. 2024;54(5):56–61.
Agency for Healthcare Research and Quality. Eliminating CLABSI, A National Patient Safety Imperative: Final Report Companion Guide. Accessed June 10, 2025. https://www.ahrq.gov/hai/cusp/clabsi-final-companion/index.html.
Centers for Medicare and Medicaid Services. Hospital-Acquired Condition Reduction Program. Accessed June 10, 2025. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-acquired-condition-reduction-program-hacrp.
Press Ganey. Press Ganey National Database of Nursing Quality Indicators (NDNQI). Accessed June 10, 2025. https://Info.Pressganey.Com/Press-Ganey-Blog-Healthcare-Experience-Insights/Your-Comprehensive-Guide-to-the-Press-Ganey-National-Database-of-Nursing-Quality-Indicators-Ndnqi.
Laux L, McGonigal M, Yaglowski J, Vietmeier S. Engaging the front line: a case study on implementing lean methodology to improve central line-associated bloodstream infections. Crit Care Nurs Q. 2022;45(4):300–306.
Yaglowski JJ. All-inclusive central line dressing kits: a lean approach. Crit Care Nurs Q. 2020;43(1):99–106.
Contributed Indexing:
Keywords: A3 problem solving; CLABSIs; central line–associated bloodstream infections; lean approach; quality improvement
Entry Date(s):
Date Created: 20251020 Date Completed: 20251020 Latest Revision: 20251020
Update Code:
20251020
DOI:
10.1097/NSG.0000000000000272
PMID:
41111191
Database:
MEDLINE

Weitere Informationen

Abstract: This article examines the application of the A3 problem-solving methodology, one of the foundations of lean quality improvement, within a level 1 trauma center. Using the example of central line-associated bloodstream infections (CLABSIs), this article demonstrates how the A3's structured approach supports systematic and sustainable process improvement. The A3's standardized format and emphasis on data-driven decision-making, combined with bottom-up staff engagement, enabled a significant reduction in CLABSIs and improved staff knowledge. The findings highlight the A3's adaptability and effectiveness in addressing complex health care challenges, encouraging a culture of continuous improvement, and contributing to enhanced patient safety and reduced health care costs.
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