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Lean Six Sigma in healthcare: Fast track surgery for patients undergoing prosthetic hip replacement surgery

Giovanni Improta (Department of Public Health, Universita degli Studi di Napoli Federico II, Napoli, Italy)
Giovanni Balato (Department of Public Health, Universita degli Studi di Napoli Federico II, Napoli, Italy)
Carlo Ricciardi (Department of Advanced Biomedical Sciences, Universita degli Studi di Napoli Federico II, Napoli, Italy)
Mario Alessandro Russo (Department of Public Health, Universita degli Studi di Napoli Federico II, Napoli, Italy)
Ida Santalucia (Department of Public Health, Universita degli Studi di Napoli Federico II, Napoli, Italy)
Maria Triassi (Department of Public Health, Universita degli Studi di Napoli Federico II, Napoli, Italy)
Mario Cesarelli (Department of Electrical Engineering and Information Technologies, Universita degli Studi di Napoli Federico II, Napoli, Italy)

The TQM Journal

ISSN: 1754-2731

Article publication date: 8 May 2019

Issue publication date: 21 June 2019

Abstract

Purpose

Since healthcare spending accounts for approximately 6.6 per cent of the gross domestic product, reducing waste in health facilities is necessary to generate significant cost savings. After previous work concerning the application of Lean Six Sigma (LSS) to hip surgery, the purpose of this paper is to use LSS as the correct methodology to analyse a clinical pathway. Fast track surgery was introduced to the Complex Operative Unit of Orthopaedic and Traumatology of the University Hospital “Federico II” to improve quality and further reduce costs associated with prosthetic hip replacement surgery.

Design/methodology/approach

The DMAIC (Define, measure, analyse, improve, control) roadmap was used as the typical problem-solving approach of the LSS methodology. A rigorous process of defining, measuring, analysing, improving and controlling business problems can be used to reach fixed goals. The paper was written following the Standards for Quality Improvement Reporting Excellence (SQUIRES Guidelines).

Findings

In this work, the authors found that multiple variables could influence the length of hospital stay (LOS) for inpatient treatment, thereby increasing patient management costs due to longer periods of hospitalisation. Therefore, LSS analysis of the implemented corrective actions demonstrated the efficacy and efficiency of the novel protocol. The average LOS was reduced from 10.66 to 7.8 days (−26.8 per cent).

Originality/value

The introduction of fast track surgery was validated through a rigorous LSS analysis, which demonstrated that the new protocol benefitted both patients and the hospital.

Keywords

Acknowledgements

The authors declare they have no conflict of interests. The authors received no funding.

Citation

Improta, G., Balato, G., Ricciardi, C., Russo, M.A., Santalucia, I., Triassi, M. and Cesarelli, M. (2019), "Lean Six Sigma in healthcare: Fast track surgery for patients undergoing prosthetic hip replacement surgery", The TQM Journal, Vol. 31 No. 4, pp. 526-540. https://doi.org/10.1108/TQM-10-2018-0142

Publisher

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Emerald Publishing Limited

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