Using KAIZEN methodology to address process gaps identified following death audits reduces mortality rates in the Moroto Regional Referral Hospital

Introduction: In today’s busy healthcare environment, processes, procedures and system gaps lead to common threats to patient safety such as errors, incidents and delays in attending to clients. For example, a 2016 analysis published in the BMJ suggested that medical errors are the third leading cause of death in the US. At the Accident & Emergency (A&E) unit of MoRRH, the work improvement team noted flaws in the processes of receiving and attending to critically ill patients, leading to improper management (delays, wrong diagnosis, gaps in monitoring of vitals), amounting to 82% (18 of 22 sampled patients). This led to poor patient outcomes, including a weekly average of 15 deaths per month in the period July -December 2024. Methods: KAIZEN methodology focuses on removing redundant steps and streamlining workflows making operations more efficient. Using its philosophy, the WIT generated process indicators for proper management of patients and collected baseline data to make an informed situation analysis. Root causes were explored and prioritised using a feasibility matrix leading to implementation of counter measures. The counter measures included locally made protocols, rules, and 10 modular trainings of staff on management of common conditions (DM, HTN, head injuries and causes/management of unconscious patients). Results: The most improved variables were correct diagnosis and timely investigations posting 9% to 91% and 0% to 95% respectively. As a result, proper patient management improved from 16% in Oct 2024 to 82% In Feb 2025 thereby, reducing monthly mortality from 15 per month in July-Dec 2024 to 4 per month in the period Jan-June 2025. Conclusion: The integration of KAIZEN principles to identify and solve problems in clinical care has the potential to transform organizational culture from reactive to proactive management. We recommend adoption of this approach and institutionalization of 5S-CQI (KAIZEN)-TQM in health care.