Improving operating room efficiency in academic children's hospital using Lean Six Sigma methodology

Edward P. Tagge, Arul S. Thirumoorthi, John Lenart, Carlos Garberoglio, Kenneth W. Mitchell

Research output: Contribution to journalArticlepeer-review

Abstract

Background/purpose Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. Methods In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools. Results for Children's Hospital scheduled main operating room (OR) cases were analyzed, where the surgical attending followed themselves. Results Six hundred twelve cases were included in the seven Children's Hospital operating rooms (OR) over a 6-month period. Turnover Time (interval between patient OR departure and arrival of the subsequent patient) decreased from a median 41 min in the baseline period to 32 min in the intervention period (p < 0.0001). Turnaround Time (interval between surgical dressing application and subsequent surgical incision) decreased from a median 81.5 min in the baseline period to 71 min in the intervention period (p < 0.0001). Conclusion These results demonstrate that a coordinated multidisciplinary process improvement redesign can significantly improve efficiency in an academic Children's Hospital without preselecting specific services, removing surgical residents, or incorporating new personnel or technology. Study type Prospective comparative study, Level II.

Original languageEnglish
Pages (from-to)1040-1044
Number of pages5
JournalJournal of Pediatric Surgery
Volume52
Issue number6
DOIs
StatePublished - Jun 2017

ASJC Scopus Subject Areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Keywords

  • Efficiency
  • Lean Six Sigma
  • Operating room
  • Process mapping
  • Total quality improvement

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