Volume 19, Issue 5 pp. 909-914
Original Article

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

Gerard C. Niemeijer PhD MSc

Corresponding Author

Gerard C. Niemeijer PhD MSc

Master Black Belt Lean Six Sigma

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

Correspondence

Mr Gerard C. Niemeijer

Department of Lean Six Sigma (5Q202)

Martini Hospital Groningen

Postbus 30.033

9700 RM Groningen, The Netherlands

E-mail: [email protected]

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Elvira Flikweert MD

Elvira Flikweert MD

Trauma Surgeon

Department of Traumatology (Internal ZIP-code BA13), University Medical Center Groningen, Groningen, The Netherlands

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Albert Trip PhD

Albert Trip PhD

Master Black Belt Lean Six Sigma

Department of UMC staff (Internal ZIP-code LB10), University Medical Center Groningen, Groningen, The Netherlands

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Ronald J. M. M. Does PhD

Ronald J. M. M. Does PhD

Professor in Industrial Statistics

Faculty of Economics and Business, and Institute for Business and Industrial Statistics, University of Amsterdam, Amsterdam, The Netherlands

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Kees T. B. Ahaus PhD

Kees T. B. Ahaus PhD

Professor in Healthcare Management

Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands

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Anja F. Boot

Anja F. Boot

Geriatric Nurse

Scheper Hospital, Emmen, The Netherlands

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Klaus W. Wendt PhD MD

Klaus W. Wendt PhD MD

Trauma Surgeon

Department of Traumatology (Internal ZIP-code BA13), University Medical Center Groningen, Groningen, The Netherlands

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First published: 11 July 2012
Citations: 53

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.

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