ArticleBMJ open quality2023
Quality and process improvement of the multidisciplinary Heart Team meeting using Lean Six Sigma.
Article in BMJ open quality, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- A Multidisciplinary Team-Based Large Language Model Framework for Predicting Postoperative Neurological Complications in Acute Type A Aortic Dissection: Model Development and Validation Study.Journal of medical Internet research · 2026Article
- Applying a process mapping methodology to identify barriers and facilitators to social needs screener and medical-legal partnership integration into primary care facilities.Journal of clinical and translational science · 2026Article
- Affordances of Multidisciplinary Team Meetings as Team-Learning Activity: A Constraints-Led Approach for Continuous Health Profession Education.Perspectives on medical education · 2025Article
- Quality improvement initiative to improve communication domains of patient satisfaction in a regional community hospital with Six Sigma methodology.BMJ open quality · 2023Article
- The 7 Pillars of Pain Management for Minimally Invasive Cardiac Surgery.Innovations (Philadelphia, Pa.)Article
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Authors and funding
5 authors.
Funding
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Abstract
introductionThe Heart Team is a multidisciplinary meeting for shared decision-making in cardiology and cardiothoracic surgery. A quality improvement project to optimise the Heart Team was initiated after the merger of the cardiac centres of Amsterdam University Medical Centre.
methodsLean Six Sigma was applied with the purpose of improving efficiency and quality of care. Qualitative and quantitative analyses supported the multidisciplinary team during quality improvement sessions. Lean Six Sigma tools included process mapping, gemba walks, root cause analysis, line balancing, first time right, standardised work and poka-yoke.
interventionsSeven areas of improvement were introduced. Key elements were the improvement of the patient referral process, introduction of a structured agenda, task division and balanced planning of patients, better exchange of information, improved availability of diagnostics and supportive tools and information technology. Work agreements were introduced to support a positive work culture and mutual respect.
resultsLean Six Sigma designed an optimised Heart Team to improve efficiency by better resource utilisation, first time right decision-making, patient selection, complete and better access to information and elimination of waste. It leads to higher quality of decision-making by involving physicians in a more structured preparation, attendance of an imaging cardiologist, meeting duration within limits, installation of standard operating procedures, increased involvement of the referring cardiologists and a better engaged team.
conclusionsHeart Teams are essential to make evidence-based, patient-centred treatment plans for optimal patient outcomes. However, clinical practice and experience showed that it is challenging to have an efficient and effective discussion with complete patient information and to bring together healthcare professionals. The application of Lean Six Sigma resulted in an optimised Heart Team and created a best practice design for patient-centred, evidence-based decision-making. After implementation and process stability, a postintervention analysis could clarify long-term success and sustainability.
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