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

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 academicmedical center, a multidisciplinary committeewas 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 6month period. Turnover Time (interval between patient OR departure and arrival of the subsequent patient) decreased fromamedian 41min in thebaselineperiod 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. (C) 2017 Elsevier Inc. All rights reserved.