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J Eval Clin Pract. 2013 Oct;19(5):909-14. doi: 10.1111/j.1365-2753.2012.01875.x. Epub 2012 Jul 11.

The usefulness of lean six sigma to the development of a clinical pathway for hip fractures.

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1
Department of Lean Six Sigma (5Q202), Martini Hospital Groningen, Groningen, The Netherlands.

Abstract

AIMS AND OBJECTIVES:

The objective of this study was to show the usefulness of lean six sigma (LSS) for the development of a multidisciplinary clinical pathway.

METHODS:

A single centre, both retrospective and prospective, non-randomized controlled study design was used to identify the variables of a prolonged length of stay (LOS) for hip fractures in the elderly and to measure the effect of the process improvements--with the aim of improving efficiency of care and reducing the LOS.

RESULTS:

The project identified several variables influencing LOS, and interventions were designed to improve the process of care. Significant results were achieved by reducing both the average LOS by 4.2 days (-31%) and the average duration of surgery by 57 minutes (-36%). The average LOS of patients discharged to a nursing home reduced by 4.4 days.

CONCLUSION:

The findings of this study show a successful application of LSS methodology within the development of a clinical pathway. Further research is needed to explore the effect of the use of LSS methodology at clinical outcome and quality of life.

KEYWORDS:

efficiency of care; process improvement; reducing length of stay

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