Improving the total hip replacement process at University of Alberta Hospitals

In October 1988, the University of Alberta Hospitals (UAH) embarked on a Value Improvement Process (VIP) study, a forerunner to the hospital's total quality management (TQM) initiative, to improve the total hip replacement procedure. Cost analysis and comparisons with similar hospitals helped a cross-functional team identify 12 areas for improvement. The team significantly decreased costs and length of stay by standardizing preoperative procedures, decreasing the number of suppliers providing prosthetic devices, and implementing other improvements.

The overall cost of performing a total hip replacement decreased 21.2 percent. Preoperative length of stay decreased 48.1 percent, and postoperative length of stay decreased 9.4 percent. Total expenditures on orthopedic units involved in the study decreased 20.3 percent. Length of stay for all orthopedic patients also decreased from 8.6 days to 7.47 days. The number of open beds decreased 7.7 percent. The level of staff satisfaction with the study averaged 4.9 out of possible score of 5.