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...
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| Veröffentlicht in: | Journal of evaluation in clinical practice 2013-10, Vol.19 (5), p.909-914 |
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| container_title | Journal of evaluation in clinical practice |
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| creator | Niemeijer, Gerard C. Flikweert, Elvira Trip, Albert Does, Ronald J. M. M. Ahaus, Kees T. B. Boot, Anja F. Wendt, Klaus W. |
| description | 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. |
| doi_str_mv | 10.1111/j.1365-2753.2012.01875.x |
| format | Article |
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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.</description><identifier>ISSN: 1356-1294</identifier><identifier>EISSN: 1365-2753</identifier><identifier>DOI: 10.1111/j.1365-2753.2012.01875.x</identifier><identifier>PMID: 22780308</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Critical Pathways - standards ; efficiency of care ; Efficiency, Organizational ; Female ; Hip Fractures - diagnosis ; Hip Fractures - therapy ; Humans ; Length of Stay - statistics & numerical data ; Male ; Netherlands ; Operative Time ; Outcome and Process Assessment (Health Care) - methods ; Patient Admission - standards ; Patient Care Team - organization & administration ; Patient Discharge - standards ; process improvement ; Prospective Studies ; reducing length of stay ; Retrospective Studies ; Total Quality Management - organization & administration ; Trauma Centers - standards</subject><ispartof>Journal of evaluation in clinical practice, 2013-10, Vol.19 (5), p.909-914</ispartof><rights>2012 John Wiley & Sons Ltd</rights><rights>2012 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4575-ff88500020294a84e48c0125f35ff22a12cace5d40e0131d62b6f238122210e93</citedby><cites>FETCH-LOGICAL-c4575-ff88500020294a84e48c0125f35ff22a12cace5d40e0131d62b6f238122210e93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2753.2012.01875.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2753.2012.01875.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22780308$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Niemeijer, Gerard C.</creatorcontrib><creatorcontrib>Flikweert, Elvira</creatorcontrib><creatorcontrib>Trip, Albert</creatorcontrib><creatorcontrib>Does, Ronald J. M. M.</creatorcontrib><creatorcontrib>Ahaus, Kees T. B.</creatorcontrib><creatorcontrib>Boot, Anja F.</creatorcontrib><creatorcontrib>Wendt, Klaus W.</creatorcontrib><title>The usefulness of lean six sigma to the development of a clinical pathway for hip fractures</title><title>Journal of evaluation in clinical practice</title><addtitle>J Eval Clin Pract</addtitle><description>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.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Critical Pathways - standards</subject><subject>efficiency of care</subject><subject>Efficiency, Organizational</subject><subject>Female</subject><subject>Hip Fractures - diagnosis</subject><subject>Hip Fractures - therapy</subject><subject>Humans</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Netherlands</subject><subject>Operative Time</subject><subject>Outcome and Process Assessment (Health Care) - methods</subject><subject>Patient Admission - standards</subject><subject>Patient Care Team - organization & administration</subject><subject>Patient Discharge - standards</subject><subject>process improvement</subject><subject>Prospective Studies</subject><subject>reducing length of stay</subject><subject>Retrospective Studies</subject><subject>Total Quality Management - organization & administration</subject><subject>Trauma Centers - standards</subject><issn>1356-1294</issn><issn>1365-2753</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtOxCAUhonReBl9BcPSTSuX0uLChTE63qKz0LhwQZA5OB3pRWh15u2ljs5aEsJJ-P4D50MIU5LSuI7nKeW5SFgheMoIZSmhshDpYgPtri82h1rkCWUn2Q7aC2FOCOVEFNtoh7FCEk7kLnp5nAHuA9je1RACbix2oGscykXcb5XGXYO7yEzhE1zTVlB3A6SxcWVdGu1wq7vZl15i23g8K1tsvTZd7yHsoy2rXYCD33OEni4vHs-vkruH8fX52V1iMlGIxFopBSGEkfhTLTPIpIkzCcuFtYxpyow2IKYZgTgAnebsNbeMS8oYowRO-Agdrfq2vvnoIXSqKoMB53QNTR8UzbgUBaeZjKhcocY3IXiwqvVlpf1SUaIGtWquBoNqMKgGtepHrVrE6OHvK_1rBdN18M9lBE5XwFfpYPnvxurmYjJUMZ-s8mXoYLHOa_-u8oJH9Pl-rCa3bHzF76Ui_BtnJJU_</recordid><startdate>201310</startdate><enddate>201310</enddate><creator>Niemeijer, Gerard C.</creator><creator>Flikweert, Elvira</creator><creator>Trip, Albert</creator><creator>Does, Ronald J. M. M.</creator><creator>Ahaus, Kees T. B.</creator><creator>Boot, Anja F.</creator><creator>Wendt, Klaus W.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201310</creationdate><title>The usefulness of lean six sigma to the development of a clinical pathway for hip fractures</title><author>Niemeijer, Gerard C. ; Flikweert, Elvira ; Trip, Albert ; Does, Ronald J. M. M. ; Ahaus, Kees T. B. ; Boot, Anja F. ; Wendt, Klaus W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4575-ff88500020294a84e48c0125f35ff22a12cace5d40e0131d62b6f238122210e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Critical Pathways - standards</topic><topic>efficiency of care</topic><topic>Efficiency, Organizational</topic><topic>Female</topic><topic>Hip Fractures - diagnosis</topic><topic>Hip Fractures - therapy</topic><topic>Humans</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Netherlands</topic><topic>Operative Time</topic><topic>Outcome and Process Assessment (Health Care) - methods</topic><topic>Patient Admission - standards</topic><topic>Patient Care Team - organization & administration</topic><topic>Patient Discharge - standards</topic><topic>process improvement</topic><topic>Prospective Studies</topic><topic>reducing length of stay</topic><topic>Retrospective Studies</topic><topic>Total Quality Management - organization & administration</topic><topic>Trauma Centers - standards</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Niemeijer, Gerard C.</creatorcontrib><creatorcontrib>Flikweert, Elvira</creatorcontrib><creatorcontrib>Trip, Albert</creatorcontrib><creatorcontrib>Does, Ronald J. M. M.</creatorcontrib><creatorcontrib>Ahaus, Kees T. B.</creatorcontrib><creatorcontrib>Boot, Anja F.</creatorcontrib><creatorcontrib>Wendt, Klaus W.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of evaluation in clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Niemeijer, Gerard C.</au><au>Flikweert, Elvira</au><au>Trip, Albert</au><au>Does, Ronald J. M. M.</au><au>Ahaus, Kees T. B.</au><au>Boot, Anja F.</au><au>Wendt, Klaus W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The usefulness of lean six sigma to the development of a clinical pathway for hip fractures</atitle><jtitle>Journal of evaluation in clinical practice</jtitle><addtitle>J Eval Clin Pract</addtitle><date>2013-10</date><risdate>2013</risdate><volume>19</volume><issue>5</issue><spage>909</spage><epage>914</epage><pages>909-914</pages><issn>1356-1294</issn><eissn>1365-2753</eissn><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.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>22780308</pmid><doi>10.1111/j.1365-2753.2012.01875.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Aged, 80 and over Critical Pathways - standards efficiency of care Efficiency, Organizational Female Hip Fractures - diagnosis Hip Fractures - therapy Humans Length of Stay - statistics & numerical data Male Netherlands Operative Time Outcome and Process Assessment (Health Care) - methods Patient Admission - standards Patient Care Team - organization & administration Patient Discharge - standards process improvement Prospective Studies reducing length of stay Retrospective Studies Total Quality Management - organization & administration Trauma Centers - standards |
| title | The usefulness of lean six sigma to the development of a clinical pathway for hip fractures |
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