Use of Lean and Six Sigma Methodology to Improve Operating Room Efficiency in a High-Volume Tertiary-Care Academic Medical Center
Top Cited Papers
- 1 July 2011
- journal article
- Published by Wolters Kluwer Health in Journal of the American College of Surgeons
- Vol. 213 (1), 83-92
- https://doi.org/10.1016/j.jamcollsurg.2011.02.009
Abstract
Operating rooms (ORs) are resource-intense and costly hospital units. Maximizing OR efficiency is essential to maintaining an economically viable institution. OR efficiency projects often focus on a limited number of ORs or cases. Efforts across an entire OR suite have not been reported. Lean and Six Sigma methodologies were developed in the manufacturing industry to increase efficiency by eliminating non-value-added steps. We applied Lean and Six Sigma methodologies across an entire surgical suite to improve efficiency. A multidisciplinary surgical process improvement team constructed a value stream map of the entire surgical process from the decision for surgery to discharge. Each process step was analyzed in 3 domains, ie, personnel, information processed, and time. Multidisciplinary teams addressed 5 work streams to increase value at each step: minimizing volume variation; streamlining the preoperative process; reducing nonoperative time; eliminating redundant information; and promoting employee engagement. Process improvements were implemented sequentially in surgical specialties. Key performance metrics were collected before and after implementation. Across 3 surgical specialties, process redesign resulted in substantial improvements in on-time starts and reduction in number of cases past 5 pm. Substantial gains were achieved in nonoperative time, staff overtime, and ORs saved. These changes resulted in substantial increases in margin/OR/day. Use of Lean and Six Sigma methodologies increased OR efficiency and financial performance across an entire operating suite. Process mapping, leadership support, staff engagement, and sharing performance metrics are keys to enhancing OR efficiency. The performance gains were substantial, sustainable, positive financially, and transferrable to other specialties.Keywords
This publication has 18 references indexed in Scilit:
- Quality in Trauma Care: Improving the Discharge Procedure of Patients by Means of Lean Six SigmaJournal of Trauma: Injury, Infection & Critical Care, 2010
- Assessing the Evidence of Six Sigma and Lean in the Health Care IndustryQuality Management in Health Care, 2010
- The Toyota Production System Applied to the Upholstery Furniture Manufacturing IndustryMaterials and Manufacturing Processes, 2008
- High-throughput Operating Room System for Joint Arthroplasties Durably Outperforms Routine ProcessesAnesthesiology, 2008
- Using Six Sigma and Lean Methodologies to Improve OR ThroughputAORN Journal, 2007
- Improving operating room efficiency through process redesignSurgery, 2006
- A review and comparison of six sigma and the lean organisationsThe TQM Magazine, 2006
- Increasing Operating Room Efficiency Through Parallel ProcessingAnnals of Surgery, 2006
- Decreasing Turnaround Time Between General Surgery CasesJONA: The Journal of Nursing Administration, 2004
- Total Quality Management: Empirical, Conceptual, and Practical IssuesAdministrative Science Quarterly, 1995