# Lean Six Sigma Helps VA Reduce Length of Stay

Article Revised: March 27, 2019

A recent study by the Veteran’s Administration showed a significant improvement in the length of stay for total joint replacement patients. “The [Joint Replacement Program] JRP demonstrates that [Lean Six Sigma] LSS process methods can be used to improve patient care efficiency, substantially enhancing outcomes while reducing costs in a [Veterans Affairs] VA facility’s orthopedic surgery department,” Benjamin Gayed, MD,and colleagues wrote in the study. “Process changes reduced waste and were sustained, directly contributing to the complete elimination of non-VA care costs for patients undergoing [total hip arthroplasty] THA and [total knee arthroplasty] TKA, a 36% reduction in [length of stay] LOS, and a $1 million [return on investment] ROI while increasing total joint replacement volume.” Prior to the study, the total joint replacement program cost the medical center$1.4 million in 2008 and patients had an average LOS of 6.1 days. At baseline, the LOS decreased to 5.3 days and after the study and the sustainment period, LOS further decreased to 3.4 days. Compared to baseline cost and volumes, the VA-TAMMCS model yielded an annual \$1 million ROI.

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