Use of lean principals to improve flow of patients with fractured neck of femur--the HOPE study.
We describe the implementation of a care pathway for patients with fractured neck of femur (NOF) using Lean and Six Sigma principles. After introduction of the Lean pathway, 32 patients out a total of 86 (37%) with fractured NOF were admitted to the Trauma Ward within 4 hours of presentation to the hospital; prior to implementation this was 16 patients out of a total of 59 (27%). Post-Lean an earlier mean theatre start time of 8.40am was achieved, resulting in a 38 minute increase in daily theatre time. An additional 52 patients (12%) received surgery within 24 hours of admission, resulting in 1 night length of stay reduction. Lean methodology proved an effective method to guide change resulting in an improved journey for the patient and significant workflow gains.
R
R
McNamara
A
A
Butler
C
C
Baker
J
J
Mullen
B
B
Lenehan
S
S
Grimes
H
H
O'Donoghue
P
P
Evans
M
M
Liston
F
F
Cummins
F
F
Condon
D019091:Critical Pathways; D005265:Femoral Neck Fractures / Q000601:surgery*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland; D007902:Length of Stay; D010348:Patient Care Team / Q000458:organization & administration*; D058996:Quality Improvement; D012189:Retrospective Studies; D061665:Time-to-Treatment