Lean Management System Application in Creation of a Postpartum Hemorrhage Prevention Bundle on Postpartum Units

INTRODUCTION: Postpartum hemorrhage is the leading cause of maternal death worldwide. Lean management principles incorporate a family-centered improvement system making work more effective and safer. METHODS: Application of lean management principles in development of the Postpartum Hemorrhage Care Bundle and the Postpartum Hemorrhage Prevention Bundle is an innovative approach to improving patient outcomes. Implementing a bundle with high reliability requires redesign of work processes, communication, infrastructure, and sustained measurement. A lean process is a set of interventions, each of which creates value for the customer. Lean is not a new concept, but relatively new to health care. RESULT: Through simulation training over a 6-month period 100 registered nurses, physicians, and family representatives simulated the innovative approach developed by a multidisciplinary local improvement team (clinical microsystems methodology) in the maternity department of Lucile Packard Children's Hospital at Stanford. Simulation training was held at the nationally renowned Center for Advanced Pediatric and Perinatal Education. The local improvement team was able to demonstrate significant decreased response time for emergencies. CONCLUSION: Supply retrieval time decreased by 99.9%, physician response time decreased by 81%, and family-centered care increased by 100%. The Postpartum Hemorrhage Prevention Bundle could become the first national standard in prevention of postpartum hemorrhages on a postpartum unit.