The usefulness of lean six sigma to the development of a clinical pathway for hip fractures
Article first published online: 11 JUL 2012
© 2012 John Wiley & Sons Ltd
Journal of Evaluation in Clinical Practice
Volume 19, Issue 5, pages 909–914, October 2013
How to Cite
Niemeijer, G. C., Flikweert, E., Trip, A., Does, R. J. M. M., Ahaus, K. T. B., Boot, A. F. and Wendt, K. W. (2013), The usefulness of lean six sigma to the development of a clinical pathway for hip fractures. Journal of Evaluation in Clinical Practice, 19: 909–914. doi: 10.1111/j.1365-2753.2012.01875.x
- Issue published online: 23 SEP 2013
- Article first published online: 11 JUL 2012
- Manuscript Accepted: 28 MAY 2012
- efficiency of care;
- process improvement;
- reducing length of stay
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.
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.
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.
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.