TY - JOUR
T1 - Improving operating room efficiency in academic children's hospital using Lean Six Sigma methodology
AU - Tagge, Edward P.
AU - Thirumoorthi, Arul S.
AU - Lenart, John
AU - Garberoglio, Carlos
AU - Mitchell, Kenneth W.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/6
Y1 - 2017/6
N2 - 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.
AB - 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.
KW - Efficiency
KW - Lean Six Sigma
KW - Operating room
KW - Process mapping
KW - Total quality improvement
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U2 - 10.1016/j.jpedsurg.2017.03.035
DO - 10.1016/j.jpedsurg.2017.03.035
M3 - Article
C2 - 28389078
SN - 0022-3468
VL - 52
SP - 1040
EP - 1044
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 6
ER -