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Background/Objective <p>Paediatric iron deficiency, impacting growth and development in addition to anaemia, is often under-diagnosed and under-treated. This study aimed to improve the diagnosis and management of paediatric iron deficiency in our hospital using a Lean Six Sigma approach.</p> Methods <p>A five-phase Lean Six Sigma (define, measure, analyse, improve, control) intervention was conducted. Pre-intervention assessment (July–December 2022) evaluated existing diagnostic and treatment practices to identify risk areas and root causes. Specific data-driven interventions were implemented, and improvements were assessed in the post-intervention period (November 2023–April 2024).</p> Results <p>Two key problems were identified: (1) lack of a paediatric diagnostic cut-off on ferritin reports; and (2) lack of clear management guidance. Two specific interventions were implemented: (1) adding the paediatric diagnostic cut-off to ferritin reports (&lt; 45&#xa0;pmol/L); and (2) providing paediatrician education. Post-intervention, the diagnosis rate significantly increased from 54.7% (1.6 <i>σ</i>) to 86.9% (2.8 <i>σ</i>, <i>p</i> &lt; 0.001), and the iron replacement prescription rate rose from 50% (1.5 <i>σ</i>) to 75.4% (2.2 <i>σ</i>,<i> p</i> = 0.002). Control measures included a reference guide and annual training.</p> Conclusions <p>This Lean Six Sigma intervention significantly improved the diagnosis and management of paediatric iron deficiency, demonstrating its potential to enhance patient care through data-driven care enhancement. Iron deficiency could be an under-emphasised area in clinical practice, and appropriate training and guidance are necessary. Laboratories should add diagnostic cut-offs to ferritin laboratory reports to aid diagnosis and proper treatment of iron deficiency. Further study to apply LSS in other aspects of healthcare could be beneficial.</p>

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Lean Six Sigma Intervention for Improving Paediatric Iron Deficiency Diagnosis and Management

  • 期刊论文

  • 发表日期：

    2025年10月8日

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  • Wing Kit Lam,
  • Tracy Yuen Han Lee,
  • Chak Ho Li,
  • Sze Fai Yip

摘要

Background/Objective

Paediatric iron deficiency, impacting growth and development in addition to anaemia, is often under-diagnosed and under-treated. This study aimed to improve the diagnosis and management of paediatric iron deficiency in our hospital using a Lean Six Sigma approach.

Methods

A five-phase Lean Six Sigma (define, measure, analyse, improve, control) intervention was conducted. Pre-intervention assessment (July–December 2022) evaluated existing diagnostic and treatment practices to identify risk areas and root causes. Specific data-driven interventions were implemented, and improvements were assessed in the post-intervention period (November 2023–April 2024).

Results

Two key problems were identified: (1) lack of a paediatric diagnostic cut-off on ferritin reports; and (2) lack of clear management guidance. Two specific interventions were implemented: (1) adding the paediatric diagnostic cut-off to ferritin reports (< 45 pmol/L); and (2) providing paediatrician education. Post-intervention, the diagnosis rate significantly increased from 54.7% (1.6 σ) to 86.9% (2.8 σ, p < 0.001), and the iron replacement prescription rate rose from 50% (1.5 σ) to 75.4% (2.2 σ, p = 0.002). Control measures included a reference guide and annual training.

Conclusions

This Lean Six Sigma intervention significantly improved the diagnosis and management of paediatric iron deficiency, demonstrating its potential to enhance patient care through data-driven care enhancement. Iron deficiency could be an under-emphasised area in clinical practice, and appropriate training and guidance are necessary. Laboratories should add diagnostic cut-offs to ferritin laboratory reports to aid diagnosis and proper treatment of iron deficiency. Further study to apply LSS in other aspects of healthcare could be beneficial.