Abstract：
:Lean Six Sigma (LSS) is a process improvement methodology developed in the manufacturing industry to increase process efficiency while maintaining product quality. The efficacy of LSS application to the health care setting has not been adequately studied. This article presents a quality improvement project at the U.S. Naval Academy that uses LSS to improve the mass immunizations process for Midshipmen during in-processing. The process was standardized to give all vaccinations at one station instead of giving a different vaccination at each station. After project implementation, the average immunizations lead time decreased by 79% and staffing decreased by 10%. The process was shown to be in control with a capability index of 1.18 and performance index of 1.10, resulting in a defect rate of 0.04%. This project demonstrates that the LSS methodology can be applied successfully to the health care setting to make sustainable process improvements if used correctly and completely.
journal_name
Mil Medjournal_title
Military medicineauthors
Ha C,McCoy DA,Taylor CB,Kirk KD,Fry RS,Modi JRdoi
10.7205/MILMED-D-15-00247subject
Has Abstractpub_date
2016-06-01 00:00:00pages
582-8issue
6eissn
0026-4075issn
1930-613Xjournal_volume
181pub_type
杂志文章abstract：:The United States military relies on visual acuity standards to assess enlistment induction and military occupational specialty eligibility, as well as to monitor soldiers' combat vision readiness. However, these vision standards are not evidence based and may not accurately reflect appropriate standards for military ...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed-d-00-6408
更新日期：2009-04-01 00:00:00
abstract：INTRODUCTION:In 2017, over 75,000 cataract surgeries were performed within the Veterans Health Administration System (VHA). Previous reports of outcomes of cataract surgery in veterans include patients with pre-existing ocular disease, which can affect vision. To exclude the confounding factor of pre-existing ocular co...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usy375
更新日期：2019-07-01 00:00:00
abstract：:This article describes the circumstances surrounding an intense, constant pain in the temporal region (visual analog scale 9-10) experienced by a 22-year-old combat officer in the Israel Defense Forces following a mild facial injury. The officer's wound included penetration of shrapnel particles into the facial skin, ...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.172.12.1284
更新日期：2007-12-01 00:00:00
abstract：OBJECTIVE:To deliver optimal patient care and promote wellness, naval providers and patients require convenient access to medical information from isolated duty stations. The Internet can lower barriers to accessing information. The goal of this study was to determine the technical feasibility of using the Internet to ...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1998-11-01 00:00:00
abstract：:This article provides a synopsis of the limited investigations examining the impact of external load (EL) on performance of high-intensity tasks under load (HITL), EL training intervention effects on HITL performance, and injuries from EL training. Repetitive lifting tasks and initiation of locomotion, such as rapidly...
journal_title：Military medicine
pub_type： 杂志文章,评审
doi：10.7205/MILMED-D-14-00079
更新日期：2014-09-01 00:00:00
abstract：INTRODUCTION:Attention deficit hyperactive disorder (ADHD) is prevalent in 5.9-7.1% of children and adolescents, and 5% of adults. It results in poor academic, occupational, and social functioning. Pharmacotherapy improves core symptoms; however, average adherence levels are low and decrease at 16-17 years of age, just...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usy161
更新日期：2018-09-01 00:00:00
abstract：:This study describes injury and illness rates and some risk factors among soldiers from an armor division during a rotation at the National Training Center (Fort Irwin, California). Soldiers from a brigade of the 1st Cavalry Division were involved in a 5-week training exercise at the National Training Center. Health c...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.171.11.1051
更新日期：2006-11-01 00:00:00
abstract：:Malignant neoplasms of the bladder are typically transitional cell carcinoma with squamous cell carcinoma and adenocarcinoma comprising nearly all of the remaining cases. Leiomyosarcoma is a rarely seen neoplasm of the bladder with a generally poor prognosis. It is important to distinguish leiomyosarcomas from rhabdom...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.169.2.155
更新日期：2004-02-01 00:00:00
abstract：:In June 1998, six unexpected anterior cruciate ligament (ACL) ruptures within 12 months were detected by routine injury surveillance in a cohort of Australian Army recruits. Local investigation, reported separately as a Case Report in this issue, suggested the cause to be an excessive coefficient of friction between r...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：2002-04-01 00:00:00
abstract：OBJECTIVE:Intubation is a difficult skill under normal circumstances and more so with a limited visual field such as wearing a protective mask in a chemical or biological incident. This study sought to determine whether successful intubation using the intubating laryngeal mask airway (ILMA) under protective mask condit...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：2003-11-01 00:00:00
abstract：:Carotid atherosclerosis affects thousands of individuals each year. A history of transient ischemic attacks should alert the clinician to the possibility of carotid artery disease. Carotid endarterectomy is of proven benefit in both symptomatic and asymptomatic individuals, with angiographically confirmed carotid sten...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1995-03-01 00:00:00
abstract：:Rapid user-friendly ABO-Rh blood typing kits (Eldon Home Kit 2511, ABO-Rh Combination Blood Typing Experiment Kit) were evaluated to determine their accuracy when used under simulated military field conditions and after long-term storage at various temperatures and humidities. Rates of positive tests between control g...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed-d-10-00339
更新日期：2011-04-01 00:00:00
abstract：:Tuberculosis (TB) is a common disease worldwide affecting more than 2 billion people, including latent, pulmonary, and extrapulmonary TB. The presentation of disseminated TB is variable and dependent on the organs affected. Therefore, making the diagnosis and providing appropriate treatment can be delayed. We present ...
journal_title：Military medicine
pub_type： 杂志文章,评审
doi：10.7205/MILMED-D-15-00232
更新日期：2016-03-01 00:00:00
abstract：:A diminution in the anticoagulant effect of IV heparin with concomitant use of IV nitroglycerin has been reported. However, recent reports have disputed the existence of this interaction. The objective of this study was to assess the potential interaction of these agents in a clinical setting. Forty-five patients hosp...
journal_title：Military medicine
pub_type： 临床试验,杂志文章
doi：
更新日期：1994-08-01 00:00:00
abstract：INTRODUCTION:The U.S. Air Force utilizes specialized Critical Care Air Transport Teams (CCATT) for transporting "stabilized" patients. Given the drawdown of military forces from various areas of operation, recent CCATT operations have increasingly involved the evacuation of unstable and incompletely resuscitated patien...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usy371
更新日期：2019-05-01 00:00:00
abstract：:Gunshot wounds are the second leading cause of spinal cord injuries in developed countries, whereas in undeveloped and developing countries, this likelihood is much more. However, the weapon and injury characteristics are very different between those two groups of countries. The aim of this study was to review our exp...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：2002-11-01 00:00:00
abstract：:The physiological burden created by heat strain and physical exercise, also called thermal-work strain, was quantified for 10 male Marines (age 21.9 ± 2.3 years, height 180.3 ± 5.2 cm, and weight 85.2 ± 10.8 kg) during three dismounted missions in Helmand Province, Afghanistan. Heart rate (HR) and core body temperatur...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-12-00538
更新日期：2013-10-01 00:00:00
abstract：UNLABELLED:Ranger training includes strenuous physical activities and despite heat mitigations strategies, numerous cases of serious exertional heat illness (EHI) occur. We developed an Arm Immersion Cooling (AIC) system that is not logistically burdensome and may be easily employed in training environments. PURPOSE:T...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-14-00727
更新日期：2015-11-01 00:00:00
abstract：UNLABELLED:Physical therapists (PTs) serve as physician extenders performing direct access evaluations for musculoskeletal conditions. The previous war-time mission of PTs was limited to level III medical care. Recently PTs began providing care at levels I/II with brigade combat teams (BCTs). PURPOSE:Determine the sen...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed-d-09-00099
更新日期：2010-05-01 00:00:00
abstract：:Prostate cancer remains the second most commonly diagnosed cancer among the male population worldwide. Vitamin D deficiency has been linked to prostate cancer and its aggressiveness. Herein, we initiated a retrospective study to evaluate vitamin D status and monitoring in veterans with prostate cancer, and to examine ...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-12-00540
更新日期：2014-01-01 00:00:00
abstract：:The incidence of foot blisters and other overuse injuries of the lower limb is very high during basic military training (BMT). One hundred and eighty-nine subjects were divided into two intervention groups wearing alternative sock systems and one control group. Overall, 57% of the 173 recruits who completed the traini...
journal_title：Military medicine
pub_type： 杂志文章,随机对照试验
doi：10.7205/milmed-d-01-8508
更新日期：2009-02-01 00:00:00
abstract：:We report a case of a type IV hypersensitivity reaction causing oral stomatitis, presumed to be the result of common dental adhesives. The case was diagnosed using patch testing to the dental adhesives that were used in the patient. Both of the adhesives tested contained a form of acrylate that is being seen more freq...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-16-00232
更新日期：2017-03-01 00:00:00
abstract：:These tests were conducted to develop a database that could be used to assess risks to soldiers from exposure to aerosolized metallic particulates when the crew compartment of an Abrams tank is perforated by a kinetic energy penetrator. Quantitative data are reported for aerosols produced by kinetic energy penetrators...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.172.4.393
更新日期：2007-04-01 00:00:00
abstract：:American women are increasingly becoming involved in combat-related roles. Inevitably, our country will have several killed and taken prisoner. No National Academy of Science/National Research Council or VA study has ever been undertaken to examine the chronic sequelae of the experiences undergone by these captured wo...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：OBJECTIVE:To optimally practice medicine, and to live healthy lives, providers and patients need convenient access to authoritative information. The goal of this study was to determine the information needs of naval primary care providers and patients at sea to aid development of a digital health sciences library for n...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1999-02-01 00:00:00
abstract：:From April 24 to 26, 2013, the Armed Forces Health Surveillance Center and the U.S. Africa Command cosponsored the inaugural meeting of the West Africa Malaria Task Force in Accra, Ghana. The meeting's purpose was to identify common challenges, explore regional and transcontinental collaborations, and to share knowled...
journal_title：Military medicine
pub_type：
doi：10.7205/MILMED-D-14-00406
更新日期：2015-01-01 00:00:00
abstract：INTRODUCTION:Dengue fever, caused by any of the four dengue viruses (DENV1-4), is endemic in more than 100 countries around the world. Each year, up to 400 million people get infected with dengue virus. It is one of the most important arthropod-borne viral diseases. Dengue's global presence poses a medical threat to de...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usaa553
更新日期：2021-01-11 00:00:00
abstract：INTRODUCTION:Over 5,300 inguinal hernia repairs (IHR) were performed in the Military Health System in 2015. Chronic pain can be a debilitating complication, occurring in up to 34% of patients after IHR and impacts mission readiness. Gabapentin has been shown to be effective for postoperative analgesia in a variety of o...
journal_title：Military medicine
pub_type： 杂志文章,随机对照试验
doi：10.7205/MILMED-D-17-00107
更新日期：2017-11-01 00:00:00
abstract：:A case report is presented of a young male who sustained a second-degree frostbite injury to the oral cavity, to include lower lip, hard palate, tongue, and buccal mucosa. This unusual injury occurred as a result of substance abuse: an attempt to inhale an aerosolized propane propellant as a means to achieve euphoria....
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：:Tibial nonunions are a challenging situation for both healing and reconstruction when infection is added. In this retrospective study, we discuss the cases in which we had managed to obtain union by aggressive debridement, circular external fixature, and internal bone transport. Fourteen cases had been treated between...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：2002-12-01 00:00:00
