Application of a 6Sigma-Based Nursing Intervention to Improve Postoperative Recovery in Patients Undergoing Total Hip Arthroplasty: A Retrospective Study.

Aim: Total hip arthroplasty (THA) is a well-established procedure for treating various hip joint diseases. However, postoperative complications and negative outcomes can affect patient recovery and satisfaction. Conventional perioperative interventions have demonstrated limited effectiveness in addressing these challenges. This study aimed to evaluate the effectiveness of a Six Sigma-based intervention model in patients undergoing THA, with a focus on improving postoperative outcomes, reducing complications, and enhancing patient satisfaction.

Methods: A retrospective study was conducted at a single center, including 155 patients who underwent THA between February 2024 to February 2025. Patients were allocated to either a control group (n = 78), which received standard perioperative care, or an experimental group (n = 77), which received Six Sigma-based perioperative care. The intervention included preoperative education, postoperative rehabilitation guidance, and improved communication between healthcare providers and patients. Primary outcomes included postoperative complications, length of hospital stay, pain levels (visual analog scale (VAS)), hip joint function (Harris Hip Score), functional independence measure (FIM), kinesiophobia (Tampa Scale for Kinesiophobia-11 (TSK-11)), and mental health status (self-rating anxiety scale (SAS), self-rating depression scale (SDS)). Patient satisfaction was evaluated using a custom questionnaire.

Results: No significant differences were observed between the two groups regarding demographic characteristics, American Society of Anesthesiologists (ASA) classification, surgery duration, or intraoperative blood loss (p > 0.05). The experimental group experienced significantly shorter hospital stays and earlier postoperative ambulation (p < 0.001). At 8 days postoperatively, the experimental group demonstrated significantly higher Harris and FIM scores, and lower TSK-11 scores compared to the control group. Additionally, the experimental group had significantly higher activities of daily living (ADL) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale, and significantly lower SAS and SDS scores (p < 0.05). Pain scores (VAS) at 48 hours postoperatively were significantly lower in the experimental group (p < 0.001). Patient satisfaction was also significantly higher in the experimental group compared to the control group (p < 0.001).

Conclusions: The Six Sigma-based perioperative intervention significantly improved clinical outcomes in THA patients by reducing recovery time, enhancing functional recovery, and improving psychological well-being and patient satisfaction. This model represents an effective approach for optimizing perioperative care in patients undergoing THA.