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    Metodologia Lean Seis Sigma para melhoria do fluxo de alta em um centro de terapia intensiva
    (Universidade Federal de São Paulo (UNIFESP), 2020-04-30) Zimmermann, Guilherme Dos Santos [UNIFESP]; Bohomol, Elena [UNIFESP]; Universidade Federal de São Paulo
    Objective: To improve the discharge process within an adult intensive care unit by applying the Lean Six Sigma Methodology. Methods: A prospective, descriptive, exploratory, quantitative study, which followed the DMAIC (Define-Measure-Analyze-Impove-Control) development method for projects. This method was established in five stages: the project definition, the initial measurement and data collection, results assessment, process improvement and statistics monitoring. It took place within an intensive care unit in a private and tertiary hospital in São Paulo between October 2018 and May 2019. The project was approved by the Ethics Committee and all participants agreed to participate by giving the informed consent form. Results: For the first stage entitled Define, a team was formed to define the work’s scope, to elaborate the project’s definitions and to map the process. For stage two Measure, the data collection occurred to stablish the initial sigma capacity in 0,44σ, followed by stage three Analyze, where a brainstorming was held to create the Cause and Effect Diagram prioritizing three of eighteen identified problems. During Improve stage improvements were identified and applied by doing trainings to the team, stablishing goals and defining protocols. Those were monitored after their conclusion through the I-AM control chart which was made in faze Control. At the end, the sigma capacity was raised from 0.44σ to 1,93σ and caused a reduction of 189 minutes to 75 minutes in the process of the ICU discharge, corresponding to an improvement of 61%. Conclusion: The Lean Six Sigma Methodology demonstrated efficiency in reducing the discharge time in an intensive care unit with the possibility of applying quality tools and institutional process optimization.