The project “Chest x-ray? No, thanks” will be the focus of two publications later this year.
The two nurses at Humanitas Serena Pagani and Catalina Valencia have been working on a particular technique, which has been applied and in use since 2015, which aims to create a safe and waiting-less path for patients who need to have a peripheral access to a central venous catheter (also known as PICC – Peripherally Inserted Central Catheter) to start administering drugs in a timely manner.

The project was carried out following the Lean methodology, applied in Humanitas since 2012, which aims to ‘streamline’ the organization of structures and services, through innovative analysis of processes, giving added value to the services offered to patients.

The publications

After winning the award during the national competition “Lean Health Award 2018”, in Florence within the Health System Forum, for the best Lean project in the Healthcare category, the project “Chest X-ray? No thanks”, was published in the management magazine Harvard Business Review and also will become the first chapter of the book “Lean Strategy. Cases and experiences in the healthcare and lifescience sector”.

The benefits of a study applied to over 1000 patients

Before the lean project, “the patients had to wait about 3 hours for the X-ray check after the implantation of the PICC catheter. The guidelines suggested the intra-cavitary electrocardiogram as an alternative method of controlling the insertion of the tip of the catheter, performed at the same time as the positioning manoeuvre and in place of the chest plate,” explained Catalina Valencia, nurse expert in venous access.

The pilot study applied to 1200 patients confirmed the clinical validity of this method as well as the best quality for the patient, who can immediately begin pharmacological care, with a 73% reduction in waiting times due to radiographic control.

The project, carried out with the support of Giulia Goretti, responsible for the review of processes and Lean, is now used on all patients that position a PICC and the human and material resources that have been freed by the reduction of waste have been dedicated to the care of other patients.

“After many years of internal Lean competition at Humanitas – commented Giulia Goretti – for the first time we have applied in a national competition and the victory has proud of the work we have done together. A special thanks to Serena Pagani and Catalina Valencia, who working every day with patients have made it possible to achieve the results presented, and to Dr. Tiziana Fusco who, supported by Dr. Maria Martucci, presented the proposal to extend the project on CVCs.

“Writing a chapter of the book was very demanding – added Serena Pagani, nursing coordinator – : writing requires time dedicated and very precise attention to detail. What we are writing must be comprehensible to the whole public, not only to the health sector, and must convey in a few lines all the commitment and importance of the work carried out. The team spirit between me and Giulia was fundamental for the achievement of the objective and the final result filled both of them with pride”.