Lean Six Sigma: a new approach to the management of patients undergoing prosthetic hip replacement surgery. Issue 4 (11th May 2015)

• Record Type: Journal Article
• Authors: Improta, Giovanni; Balato, Giovanni; Romano, Maria; Carpentieri, Francesco; Bifulco, Paolo; Alessandro Russo, Mario; Rosa, Donato; Triassi, Maria; Cesarelli, Mario
• Is Part Of: Journal of evaluation in clinical practice. Volume 21:Issue 4(2015)
• Page Start: 662
• Page End: 672
• Publication Date: 2015-05-11
• Subjects: Clinical medicine -- Periodicals; 616.005
• DOI: 10.1111/jep.12361
• Languages: English
• ISSNs: 1356-1294

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jep12361-sec-0001" sec-type="section"> <title>Rationale, aims and objectives</title> <p>In 2012, health care spending in Italy reached €114.5 billion, accounting for 7.2% of the Gross Domestic Product (GDP) and 14.2% of total public spending. Therefore, reducing waste in health facilities could generate substantial cost savings. The objective of this study is to show that Lean Six Sigma represents an appropriate methodology for the development of a clinical pathway which allows to improve quality and to reduce costs in prosthetic hip replacement surgery.</p> </sec> <sec id="jep12361-sec-0002" sec-type="section"> <title>Methods</title> <p>The methodology used for the development of a new clinical pathway was Lean Six Sigma. Problem solving in Lean Six Sigma is the DMAIC (<italic>Define, Measure, Analyse, Improve, Control</italic>) roadmap, characterized by five operational phases which make possible to reach fixed goals through a rigorous process of defining, measuring, analysing, improving and controlling business problems.</p> </sec> <sec id="jep12361-sec-0003" sec-type="section"> <title>Results</title> <p>The following project indicated several variables influencing the inappropriate prolongation of the length of stay for inpatient treatment and corrective actions were performed to improve the effectiveness and efficiency of the process of care. The average length of stay was reduced from 18.9 to 10.6 days (−44%).</p> </sec> <sec id="jep12361-sec-0004" sec-type="section"> <title>Conclusion</title> <p>This article shows there is no trade‐off between quality and costs: Lean Six Sigma improves quality and, at the same time, reduces costs.</p> </sec> </abstract>