The DOI matches its Crossref record; 30 of the 31 references it cites were found in a registry or an index.
Improving performances of the knee replacement surgery process by applying DMAIC principles
Open accessAbstract
Rationale, Aims, and Objectives: The work is a part of a project about the application of the Lean Six Sigma to improve health care processes. A previously published work regarding the hip replacement surgery has shown promising results. Here, we propose an application of the DMAIC (Define, Measure, Analyse, Improve, and Control) cycle to improve quality and reduce costs related to the prosthetic knee replacement surgery by decreasing patients' length of hospital stay (LOS) Methods: The DMAIC cycle has been adopted to decrease the patients' LOS. The University Hospital “Federico II” of Naples, one of the most important university hospitals in Southern Italy, participated in this study. Data on 148 patients who underwent prosthetic knee replacement between 2010 and 2013 were used. Process mapping, statistical measures, brainstorming activities, and comparative analysis were performed to identify factors influencing LOS and improvement strategies. Results: The study allowed the identification of variables influencing the prolongation of the LOS and the implementation of corrective actions to improve the process of care. The adopted actions reduced the LOS by 42%, from a mean value of 14.2 to 8.3 days (standard deviation also decreased from 5.2 to 2.3 days). Conclusions: The DMAIC approach has proven to be a helpful strategy ensuring a significant decreasing of the LOS. Furthermore, through its implementation, a significant reduction of the average costs of hospital stay can be achieved. Such a versatile approach could be applied to improve a wide range of health care processes.
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“there are effects of “increase in revenue” and “costs reduction” [21,38,48].”
From Lean Healthcare Tools for Processes Evaluation: An Integrative Review. (2021) · cites this paper as [38]
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“with the use of DMAIC, the ones that stood out the most were decreased lead time, reduced length of stay and decreased costs [21,30,38,48,55].”
From Lean Healthcare Tools for Processes Evaluation: An Integrative Review. (2021) · cites this paper as [38]
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“review of work processes [38,46,47,48,49]”
From Lean Healthcare Tools for Processes Evaluation: An Integrative Review. (2021) · cites this paper as [38]
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Cerchione, R., & Esposito, E. (2016) · International Journal of Information Management · doi:10.1016/j.ijinfomgt.2016.10.007 · Cited by 215
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1 of the 31 references couldn’t be matched to a known paper.
Research works printed but not linked: 6
- ConversoG De CarliniR SantilloLC ImprotaG.Project management implementation for healthcare activities organization. Paper presented at: Advances in Computer Science Proceedings of the 6th WSEAS European Computing Conference (ECC '12) 2012; Prague Czech Republic.
- ImprotaG De RosaG VerdolivaC et al.Appropriate indicators to evaluate the technology managed by the functional direction GAT of AORN. “A. Cardarelli” in Naples. Paper presented at: 15th International Conference on Industrial Engineering and Management Science (ICIEMS)2013.
- ImprotaG ParenteG TriassiM et al.Evaluation of a set of indicators devoted to the service of health education: the case of the Biotechnology Centre of the AORN Hospital “A. Cardarelli” in Naples. Paper presented at: 15th International Conference on Industrial Engineering and Management Science (ICIEMS)2013.
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Items 101–103 of 103
A Novel Based Clinical Support System Creation for an Emergency Clinical Needs via FLBA
Raman, R., Pillai, B. G., Rastogi, S., Kumar, V., Verma, A., & Meenakshi, R. (2024) · International Conference on Advance Computing and Innovative Technologies in Engineering (ICACITE) · doi:10.1109/icacite60783.2024.10617095
Systematic Review of DMAIC for Quality Monitoring and Control: A Case Study in the Mining Industry
Nkabinde, S., Mofokeng, V., & Nyakala, K. S. (2025) · IEEE International Conference on Mechanical and Intelligent Manufacturing Technologies (ICMIMT) · doi:10.1109/icmimt65123.2025.11092046
Penerapan Lean Six Sigma untuk Meningkatkan Keselamatan Pasien (Patient Safety) di Rumah Sakit
Saphira, M. Z., Putri, N. N. S., & Iswanto, A. H. (2026) · Pratama Medika Jurnal Kesehatan · doi:10.56480/pratamamedika.v5i2.77
Metadata
- Authors
- Improta, G., Balato, G., Romano, M., Ponsiglione, A. M., Raiola, E., Russo, M. A., Cuccaro, P., Santillo, L. C., & Cesarelli, M.
- Affiliations
- University of Naples Federico II (IT)
- Magna Graecia University (IT)
- Federico II University Hospital (IT)
- Fondazione Salvatore Maugeri (IT)
- Corresponding author
- Improta, Giovanni
- ORCID
- Venue
- Journal of Evaluation in Clinical Practice
- Publisher
- Wiley
- Published
- 2017-09-26
- Volume
- 23
- Issue
- 6
- Pages
- 1401-1407
- ISSN
- 1356-1294 (ISSN-L)
- 1365-2753
- PMC
- PMC6585639
- OpenAlex
- W2758975722
- Cited by
- 105
- References
- 31
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 9 · 2022: 14 · 2021: 36 · 2020: 22 · 2019: 10 · 2018: 3 · 2017: 2
- FWCI
- 13.89
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Evaluation in Clinical Practice (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
- Social Sciences › Decision Sciences › Management Science and Operations Research › Healthcare Operations and Scheduling Optimization
- Social Sciences › Business, Management and Accounting › Management Information Systems › Quality and Supply Management
- Keywords
- knee arthroplasty, length of hospital stay, DMAIC, Lean Six Sigma, process improvement, hospital costs, surgical process, process mapping, healthcare quality improvement
- MeSH terms
- Aged, Aged, 80 and over, Cost-Benefit Analysis, Female, Humans, Interprofessional Relations, Italy, Length of Stay, Male, Middle Aged, Patient Care Team, Efficiency, Organizational, Total Quality Management, Arthroplasty, Replacement, Knee, Quality Improvement
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