Table 2 Summary of key characteristics of papers

Nimeri, A. A., Bautista, J., & Philip, R. (2019). Reducing healthcare costs using ACS NSQIP-driven quality improvement projects: a success story from Sheikh Khalifa Medical City (SKMC). World journal of surgery, 43(2), 331–338

Sheikh Khalifa Medical City’s surgical services Abu Dhabi, UAE

2009–15

Reduction in 4 Hospital Acquired Complications for all surgical patients during the study period

Targeted Quality Improvement

1. VTE reduction from 7/1646 to 26/ 7196, preventing 12 @ $28,000 for savings of $336,000; 2. UTI prevented 56 ($728,000) and SSI prevented 12 ($336,000); 3. UI prevented 4 ($84,000) and Vent > 48 h occurrences prevented was 7 ($196,000)

Chatfield SC, Volpicelli FM, Adler NM, et al. Bending the cost curve: time series analysis of a value transformation programme at an academic medical centre BMJ Qual Saf 2019;28:449–458

Tish Hospital NYU Langone Health, New York, United States

Baseline 2011–14; Post 2014–17

74 initiatives in acute clinical care services during study period

Standardised process improvement model

Fully adjusted total variable direct costs per case declined an average of 0.22% per month relative to baseline trends; net overall reduction in costs of 7.7% by the end of the study period relative to the expected cost without intervention

Lee, V. S., Kawamoto, K., Hess, R., Park, C., Young, J., Hunter, C., Pendleton, R. C. (2016). Implementation of a Value-Driven Outcomes Program to Identify High Variability in Clinical Costs and Outcomes and Association With Reduced Cost and Improved Quality. JAMA, 316(10), 1061–1072

University of Utah Health Care Utah, United States

July 1, 2014, to June 30, 2015

3 Clinical care projects: total hip and knee joint replacement; hospitalist laboratory utilization; and management of sepsis

Multiple PI methods specified including care process redesign, continuous improvement and

process improvement and standardization

Mean direct costs were 7% lower in the implementation year (95%CI, 3%-11%;P < .001) and 11% lower in the post implementation year (95%CI, 7%-14%; P < .001)

Gabow, P. A. (2014). The Lean Prescription: Powerful Medicine for Our Ailing Healthcare System (1st ed.): OR: Productivity Press

Denver Health Colorado, United States

2005–2012

Whole of hospital – all patients

Lean

Almost $200 million of financial benefit over seven years with $50 million in 2012 alone

Barnas, K. (2011) ThedaCare’s Business Performance System: Sustaining Continuous Daily Improvement Through Hospital Management in a Lean Environment. The Joint Commission Journal on Quality and Patient Safety, 37( 9), 387–399

ThedaCare, Wisconsin, United States

2003–2008

Whole of hospitals

Lean

11 (48%) of the 23 financial stewardship drivers in 2010 compared to 2009 Specific improvement projects: The Collaborative Care Delivery Model: average decrease in cost per case of 22%. The Staffing to Patient Demand $895,000 salary savings Radiation Oncology Value Stream increased gross revenue by 24%,

Vincent Martinez Ibañez, Anna Ochoa de Echagüen, Antonio Campos & Soledad Romea (2021) Creating efficient professional healthcare organizations, International Journal of Healthcare Management, https://doi.org/10.1080/20479700.2020.1870347

University hospital Catalonia, Spain

2015–2018

Five processes or value streams: surgery; hospitalization; outpatient care; intensive care; and emergencies

Lean and Design Thinking

Financial results from the surgery stream only were reported to be a saving of 8,563,817 € through reducing waste and reordering surgical schedule and a revenue of increase of 600,044 € due to increasing surgical activity

Khowaja AR, Willms AJ, Krause C, Carriere S, Ridout B, Kennedy C, et al. The Return on Investment of a Province-Wide Quality Improvement Initiative for Reducing In-Hospital Sepsis Rates and Mortality in British Columbia, Canada. Critical Care Medicine. 2022;50(4):e340-e50

36 hospitals within British Columbia (excluding Quebec and three territories)

2014—2018

Retrospective data for all in-hospital sepsis cases and sepsis mortality

Collaborative

An estimated 981 sepsis cases and 172 deaths were averted in the post-British Columbia Sepsis Network period (2014–2018). The total cost, including the development and implementation of British Columbia Sepsis Network, was $449,962. Net savings due to cases averted after program costs were considered were $50.6 million in 2018. This translates into a return of $112.5 for every dollar invested