The Study Of Lean Six Sigma Applications In Decrease Of Average Length Of Stay

Average length of stay (ALOS) is one of the major comprehensive indicators used to evaluate inpatient effectiveness and efficiency. Besides the medical technique and talent staffs, ALOS also depends on the hospital inpatients operation. The decrease of ALOS could save the inpatients' cost, increase turnover rate, and customers satisfactory. That's why the American medical institutions have chose ALOS as an indicator to improve the inpatient operation process for decades.The Lean six sigma, which aims to eliminate process waster and improve quality and efficiency, is the combination of Lean and sixsigma methodology. Which is wildly used in many industries, especially in the medical service industry these years. We use Lean methodology to decrease the operation cost while maintain and even improve the medical quality. Through the abroad and domestic cases, the Lean is a highly efficient way to drive the multilaterals satisfactory among medical supervisor, medical service suppliers and patients. Few hospitals in china applied Lean in medical related improvement, let alone the usage in shortening the ALSO.The study focused on two clinic wards (ward A, word B), applied Sixsigma DMAIC phases and lean tools to conduct the whole ALOS project. Which could be deployed in the following steps: the analyses of the whole operation inpatient process, the assessment and TVA analyze in the each sub-process (from admission to discharge), and the corresponding kaizen action workout.We got from the SPSS statistic outcome that over 50% inpatients would wait 4~8 days before the operation (the max is 55 days in ward B). And we got from minitab comparison that whether to receive the CT/MRI scan also showed statistic differences to the length of stay before the operation. We also detected the operation rooms' usage in the project and got positive feedback.We organized the cross function team to focus on the shortage found in the assessment. In the later kaizen events, we updated the HIS and LIS system, set up standard admission guide, established the pre-dismiss process and e-version lab check report transmission system, which all got positive feedback in eliminating and shortening the process cycle time.The ALOS pilot wards decreased by 0.63 days and 0.75 days accordingly. We used CD diagnosis matrix to reshuffle the input data. The outcome was slightly more positive, which decreased 0.73 days and 1 day in type B and type C diagnosis. All the data showed the significantly improvement in the project impact.The study that introduced the abroad practical management to improve the domestic hospital operation efficiency has also built up an effective and practical mechanism for the consideration to domestic medial institutions.