Structured syncope care pathways based on lean six sigma methodology optimises resource use with shorter time to...

Area of Science:

• Healthcare Management
• Process Improvement
• Clinical Pathways

Background:

• Syncope and Transient Loss of Consciousness (TLoC) management requires efficient care pathways.
• Current pathways may not fully comply with established guidelines (ESC/NICE).
• Optimizing diagnostic processes is crucial for timely and accurate diagnosis.

Purpose of the Study:

• To pilot the use of Lean Six Sigma methodology for optimizing syncope/TLoC management pathways.
• To assess the feasibility of improving care while adhering to ESC and/or NICE guidelines.
• To evaluate the impact of a structured methodology on diagnostic efficiency and yield.

Main Methods:

• A 3-phase Lean Six Sigma approach (Assessment, Improvement, Sustaining) was implemented across five European hospitals.
• Baseline performance was mapped, new operational models developed, and standardized tools introduced.
• Key metrics evaluated included time to diagnosis, diagnostic yield, test utilization, and guideline compliance.

Main Results:

• A 59% reduction in average time to diagnosis was observed (p=0.048).
• Diagnostic yield increased by 75% (p=0.007).
• Significant reduction in repeated diagnostic tests and improved test prioritization were noted.

Conclusions:

• Lean Six Sigma methodology offers a structured approach to enhance syncope management pathways.
• The pilot study demonstrated significant improvements in time to diagnosis and diagnostic yield.
• This methodology holds potential for optimizing clinical processes in syncope care.