Lean methods to improve operating room elective first case on-time starts in a large, urban, safety net medical center

Delays in first cases contribute to multiple operating room (OR) inefficiencies and decreases in OR productivity. Lean process improvement methods were used to redesign the existing workflow for elective first cases of the day in a large, urban, public hospital. First case start times were prospecti...

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Bibliographic Details
Published in:The American journal of surgery 2018-08, Vol.216 (2), p.194-201
Main Authors: Coffey, Charles, Cho, Edward S., Wei, Eric, Luu, Allison, Ho, Maria, Amaya, Rodolfo, Pecson, Marie, Dalton, Florence V., Kahaku, Deborah, Spellberg, Brad, Sener, Stephen F.
Format: Article
Language:English
Subjects:
Communication
Consent
Efficiency
Health care facilities
Hospitals
Lean
Medical records
Operating room
Patient satisfaction
Physicians
Problem solving
Productivity
Redesign
Schedules
Start time
Surgeons
Workflow
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Summary:Delays in first cases contribute to multiple operating room (OR) inefficiencies and decreases in OR productivity. Lean process improvement methods were used to redesign the existing workflow for elective first cases of the day in a large, urban, public hospital. First case start times were prospectively recorded from May 2, 2016 through December 29, 2017. Data from 415 operating days were examined, 86 days prior to, 35 days during, and 294 days after implementation of interventions in the pre-operative holding area. During this time, of 23,891 operations performed, 14,981 were elective procedures, 5963 (39.8%) of which were first cases of the day. The mean rate of elective first case on-time starts per week went from 23.5% before and during to 73.0% after implementation of lean interventions (p 
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2018.05.002