Copyright © 2013 American Medical Association. All rights reserved. From: Redesigning a Joint Replacement Program Using Lean Six Sigma in a Veterans Affairs Hospital JAMA Surg. 2013;148(11):1050-1056. doi:10.1001/jamasurg.2013.3598 Figure Legend: Summary of Events and ChangesBID indicates twice daily; DC, discharge; PT, physical therapy; and SW, social work. Date of download: 10/18/2017 Copyright © 2013 American Medical Association. All rights reserved.

Copyright © 2013 American Medical Association. All rights reserved. From: Redesigning a Joint Replacement Program Using Lean Six Sigma in a Veterans Affairs Hospital JAMA Surg. 2013;148(11):1050-1056. doi:10.1001/jamasurg.2013.3598 Figure Legend: Monthly Length of Stay Average Control ChartThe shaded area represents the project implementation period. The mean length of stay (LOS) (after adjusting for covariates) for the preproject, project, and sustainment periods are displayed above the chart (P < .001). CL indicates center line; LCL, lower control limit; and UCL, upper control limit. Date of download: 10/18/2017 Copyright © 2013 American Medical Association. All rights reserved.

Copyright © 2013 American Medical Association. All rights reserved. From: Redesigning a Joint Replacement Program Using Lean Six Sigma in a Veterans Affairs Hospital JAMA Surg. 2013;148(11):1050-1056. doi:10.1001/jamasurg.2013.3598 Figure Legend: Non–Veterans Affairs Care CostsThe non–Veterans Affairs care costs for total hip arthroplasty and total knee arthroplasty are shown for fiscal years 2008 through 2012. Date of download: 10/18/2017 Copyright © 2013 American Medical Association. All rights reserved.

Copyright © 2013 American Medical Association. All rights reserved. From: Redesigning a Joint Replacement Program Using Lean Six Sigma in a Veterans Affairs Hospital JAMA Surg. 2013;148(11):1050-1056. doi:10.1001/jamasurg.2013.3598 Figure Legend: Veterans Affairs and Non–Veterans Affairs Care for Total Joint Replacement Cases per YearThe number of cases of total hip arthroplasty and total knee arthroplasty in Veterans Affairs (VA) and non-VA care are shown for fiscal years 2008 through 2012. The proportion of patients using non-VA care showed a statistically significant decrease each year (P < .05). Date of download: 10/18/2017 Copyright © 2013 American Medical Association. All rights reserved.