ArticleInternational journal of environmental research and public health2021
Lean Six Sigma Approach for Reducing Length of Hospital Stay for Patients with Femur Fracture in a University Hospital.
Article in International journal of environmental research and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- The management of healthcare-related infections through lean methodology: systematic review and meta-analysis of observational studies.Journal of preventive medicine and hygiene · 2022Pooled it
- Efficiency measures of emergency departments: an Italian systematic literature review.BMJ open quality · 2021Pooled it
- Six Sigma in Health Literature, What Matters?International journal of environmental research and public health · 2021Pooled it
- A Lean-based Digital Twin model for planning and governance in secondary and tertiary hospital networks.BMC health services research · 2026Article
- Six Sigma and Statistical Process Control in Clinical Pathway Management: An Evaluation Using Coefficient of Variation, Control Charts, and Process Performance Index.Risk management and healthcare policy · 2026Article
- A scenario-driven simulation approach to sustainable hospital resource management: aging society, pandemic preparedness and referral enhancement.BMC health services research · 2025Article
- Management of Patients with Colorectal Cancer through Fast-Track Surgery.International journal of environmental research and public health · 2024Article
- The classification algorithms to support the management of the patient with femur fracture.BMC medical research methodology · 2024Article
- Lean Six Sigma Approach to Improve the Management of Patients Undergoing Laparoscopic Cholecystectomy.Healthcare (Basel, Switzerland) · 2024Article
- Implementation of Lean Management Tools Using an Example of Analysis of Prolonged Stays of Patients in a Multi-Specialist Hospital in Poland.International journal of environmental research and public health · 2023Article
- FACTORS ASSOCIATED WITH THE OUTCOMES OF OLDER PATIENTS OPERATED DUE TO HIP FRACTURES.Acta ortopedica brasileira · 2023Article
- Predictive analysis of lower limb fractures in the orthopedic complex operative unit using artificial intelligence: the case study of AOU Ruggi.Scientific reports · 2022Article
- Multiple regression model to analyze the total LOS for patients undergoing laparoscopic appendectomy.BMC medical informatics and decision making · 2022Article
- Is It Possible to Predict the Length of Stay of Patients Undergoing Hip-Replacement Surgery?International journal of environmental research and public health · 2022Article
- Machine Learning and Lean Six Sigma to Assess How COVID-19 Has Changed the Patient Management of the Complex Operative Unit of Neurology and Stroke Unit: A Single Center Study.International journal of environmental research and public health · 2022Article
- Machine Learning and Regression Analysis to Model the Length of Hospital Stay in Patients with Femur Fracture.Bioengineering (Basel, Switzerland) · 2022Article
- Regression Models to Study the Total LOS Related to Valvuloplasty.International journal of environmental research and public health · 2022Article
- Predictive Analysis of Healthcare-Associated Blood Stream Infections in the Neonatal Intensive Care Unit Using Artificial Intelligence: A Single Center Study.International journal of environmental research and public health · 2022Article
- The Use of Lean Six Sigma Methodology in the Reduction of Patient Length of Stay Following Anterior Cruciate Ligament Reconstruction Surgery.International journal of environmental research and public health · 2022Article
- DMAIC methodology for achieving public satisfaction with health departments in various districts of Punjab and optimizing CT scan patient load in urban city hospitals.AIMS public health · 2022Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Surgical intervention within 48 h of hospital admission is the gold standard procedure for the management of elderly patients with femur fractures, since the increase in preoperative waiting time is correlated with the onset of complications and longer overall length of stay (LOS) in the hospital. However, national evidence demonstrates that there is still the need to provide timely intervention for this type of patient, especially in some regions of central southern Italy. Here we discuss the introduction of a diagnostic-therapeutic assistance pathway (DTAP) to reduce the preoperative LOS for patients undergoing femur fracture surgery in a university hospital. A Lean Six Sigma methodology, based on the DMAIC cycle (Define, Measure, Analyze, Improve, Control), is implemented to evaluate the effectiveness of the DTAP. Data were retrospectively collected and analyzed from two groups of patients before and after the implementation of DTAP over a period of 10 years. The statistics of the process measured before the DTAP showed an average preoperative LOS of 5.6 days (standard deviation of 3.2), thus confirming the need for corrective actions to reduce the LOS in compliance with the national guidelines. The influence of demographic and anamnestic variables on the LOS was evaluated, and the impact of the DTAP was measured and discussed, demonstrating the effectiveness of the improvement actions implemented over the years and leading to a significant reduction in the preoperative LOS, which decreased to an average of 3.5 days (standard deviation of 3.60). The obtained reduction of 39% in the average LOS proved to be in good agreement with previously developed DTAPs for femur fracture available in the literature.
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