Innovation of Sanitization Procedures for Mechanical Ventilators Using Six Sigma Methodology

During the years 2018, 2019 and 2020, the National Institute of Respiratory Diseases (INER, its acronym in Spanish) had an increase in ventilator-associated pneumonia of 12%, 53%, and 77%, respectively. In the last year, the increase was much higher due to the care of critically ill COVID-19 patients who required mechanical ventilation. Currently, INER has 292 mechanical ventilators from 16 different brands, with varying ages. Therefore, the objective of this study was to analyze and improve the sanitization procedures of these medical devices using the Six Sigma methodology. Three procedures were studied: 1) Ventilator cleaning; 2) Disinfection of reusable accessories, and 3) High-level disinfection for mechanical ventilators. In total, five non-value-added activities and four areas of opportunity were identified. Seven innovations were proposed and implemented in a four-week pilot program, resulting in an average improvement of 76% in procedure execution.