The usefulness of Lean Six Sigma to the development of a clinical pathway for hip fractures

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.