In October 2018, three spinal surgeons published an article detailing how they applied the Plan-Do-Study-Act methodology to the surgeries they performed. All three praised the methodology for offering a systematic, straightforward approach to something as complicated as spinal surgery.

The surgeons published a report on their usage of PDSA. The report concluded that while there wasn’t an outright solution to rising American healthcare costs, philosophies like Lean Six Sigma represented a step in the right direction. By focusing on simple efficiencies and small components of the immense healthcare system, the surgeons felt that they could create lasting, meaningful change over time.

That opinion is starting to spread to other sectors of the healthcare industry.

Lean Six Sigma Has Already Proven its Worth in Healthcare

In 2014, the Children’s National Health System ran a test to pioneer a new care pathway for children with adolescent idiopathic scoliosis, who needed spinal fusion surgery.

Matthew Oetgen, M.D. – Children’s National Health System’s Chief of Orthopaedic Surgery and Sports Medicine – wanted to…

  • Shorten the overall length of each patient’s hospital stay
  • Reduce the need for opioid pain medication
  • Deliver coordinated, comprehensive care to every patient

… without increasing costs.

Dr. Oetgen and his team designed the care pathway using Lean Six Sigma principles, and after more than two years of tests, they’ve published their results in the Journal of Bone and Joint Surgery.

Spoilers: it worked.

“Our primary goal was to improve the value of care for children with scoliosis and their families,” Oetgen said in a press release. “Even better, we’ve shown that this model can be used consistently over time to maintain the benefits it delivers to this patient population.”

He’s hoping the success of the model leads to its sector-wide adoption.

“We used proven business models for culture change that were critical to the success of this program,” Oetgen said. “We’re proud of the model we have created and think it would work well in other pediatric hospitals with similar patient populations.”

Results of the Testing

From March 2015 to July 2017, Oetgen’s team tested their Lean Six Sigma-inspired care pathway on 169 patients. Here’s what they found…

  • These patients had lower postoperative pain scores (compared to those patients who didn’t participate in the new pathway)
  • They used far fewer opioids
  • Perioperative transfusion requirements were significantly lower
  • Postoperative lengths of stay were dramatically reduced

The results were consistently sustained for the entire two-and-a-half-year testing process. That means, Oetgen argues, this new care pathway is a sustainable way to improve the wellbeing of patients who are undergoing spinal fusion surgery.

Lean Six Sigma is a Mainstay in Healthcare

Lean Six Sigma isn’t new to healthcare. Those organizations who use it – like Children’s National Health System – have been experiencing its benefits for years.

That’s why, in recent years, we’ve seen healthcare organizations partner with university Lean Six Sigma programs. We’ve even seen healthcare companies like McLaren Greater Lansing train its entire staff on Six Sigma.

The application of process improvement in healthcare doesn’t just lead to efficient care and cost savings. It can lead to better lives for the patients and the staff members who support them.