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  1. Lavin, Patricia MS, RN, NEA-BC
  2. Vetter, Mary Jo DNP, RN, AGPCNP-BC


Background: Evidence-based quality improvement (EBQI) is an established methodology for identifying nursing practice changes that improve health care quality and safety. However, EBQI itself does not provide a framework for navigating the barriers to practice change.


Local Problem: An EBQI program in an orthopedic specialty hospital fostered many successful quality improvement projects. However, program participants frequently encountered barriers to project implementation.


Methods: Lean Six Sigma (LSS) principles, tools, and strategies were incorporated into the EBQI program to help participants overcome organizational barriers to successful implementation.


Interventions: LSS interventions included stakeholder alignment, process analysis, change management, project management, structured check-ins, mentoring, and organizational recognition.


Results: The addition of LSS principles gave EBQI project leaders new tools for gaining executive support, securing resources, and overcoming organizational inertia to facilitate effective practice change.


Conclusions: Lean Six Sigma can increase the effectiveness of an EBQI program.