Releasing Operating Room Nursing Time to Care through the Reduction of Surgical Case Preparation Time: A Lean Six Sigma Pilot Study

Healthcare systems internationally are working under increasing demand to use finite resources with greater efficiency. The drive for efficiency utilises process improvement methodologies such as Lean Six Sigma. This study outlines a pilot Lean Six Sigma intervention designed to release nursing time to care within a peri-operative environment; this was achieved by collaborating with stakeholders to redesign the process for laparoscopic hernia surgical case preparation (set up) material. Across 128 laparoscopic hernia surgical cases, the pilot resulted in a 55% decrease in overall nursing time spent in gathering and preparing materials for laparoscopic hernia surgical cases, with a corresponding reduction in packaging waste. The major impact of releasing nursing time to care within busy Operating Room environments enabled nurses to focus on continuing to deliver high-quality care to their patients and reduce pressure expressed by the Operating Room nurses. The results have led to an ongoing review of other surgical procedures preparation to further release nursing time and will be of interest to perioperative teams internationally.

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Using Lean Six Sigma to Redesign the Supply Chain to the Operating Room Department of a Private Hospital to Reduce Associated Costs and Release Nursing Time to Care

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111011 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11011

Author(s):

Lisa O’Mahony ◽

Kerrie McCarthy ◽

Josephine O’Donoghue ◽

Seán Paul Teeling ◽

Marie Ward ◽

...

Keyword(s):

Supply Chain ◽

Supply Chain Management ◽

Operating Room ◽

Six Sigma ◽

Private Hospital ◽

Lean Six Sigma ◽

Stock Management ◽

Nursing Time ◽

Post Intervention ◽

Chain Management

Continuity of the supply chain is an integral element in the safe and timely delivery of health services. Lean Six Sigma (LSS), a continuous improvement approach, aims to drive efficiencies and standardisation in processes, and while well established in the manufacturing and supply chain industries, also has relevance in healthcare supply chain management. This study outlines the application of LSS tools and techniques within the supply chain of an Operating Room (OR) setting in a private hospital in Dublin, Ireland. A pre-/post-intervention design was employed following the Define, Measure, Analyse, Improve, Control (DMAIC) framework and applying LSS methodology to redesign the current process for stock management both within the OR storage area and within a pilot OR suite, through collaborative, inclusive, and participatory engagement with staff. A set of improvements were implemented to standardise and streamline the stock management in both areas. The main outcomes from the improvements implemented were an overall reduction in the value of stock held within the operating theatre by 17.7%, a reduction in the value of stock going out of date by 91.7%, and a reduction in the time spent by clinical staff preparing stock required for procedures by 45%, all demonstrating the effectiveness of LSS in healthcare supply chain management.

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Critical success factors of Lean Six Sigma deployment: a current review

International Journal of Lean Six Sigma ◽

10.1108/ijlss-04-2015-0011 ◽

2015 ◽

Vol 6 (4) ◽

pp. 339-348 ◽

Cited By ~ 37

Author(s):

Fairul Anwar Abu Bakar ◽

Khairanum Subari ◽

Mohd Amran Mohd Daril

Keyword(s):

Six Sigma ◽

Critical Success Factors ◽

Success Factors ◽

Lean Six Sigma ◽

Success Story ◽

Content Type ◽

Critical Success ◽

Improvement Methodologies ◽

Practical Implications ◽

A Current

Purpose – The purpose of this paper is to review and gather the latest critical success factors (CSF) of Lean Six Sigma (LSS) deployment and implementation into a comprehensive list of factors. Design/methodology/approach – The approach taken by authors in this study was to analyze the latest literature review starting 2010 onwards and focus on CSFs of LSS (not dedicated as Lean or Six Sigma) by excluding other improvement methodologies or initiatives, e.g. Lean, Six Sigma, TQM, TRIZ etc. Findings – Five significant CSFs were identified (initially 97 CSFs listed from 13 papers) out of nine groups/headers listed in clustering analysis using Affinity Diagram tool and new headers mapping. Practical implications – Most of the organisations were aware of the success story on LSS, but did not scrutinize or consider its CSFs. By knowing the outcome of this paper, it can help open eyes regarding readiness before implementing LSS. Originality/value – At the end of this paper, the authors tried to cluster the CSFs similarities that could intentionally provide the guidelines and references to industries/companies for successful deployment and implementation of LSS in future endeavours.

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First-case tardiness reduction in a tertiary academic medical center operating room: A lean six sigma perspective

Perioperative Care and Operating Room Management ◽

10.1016/j.pcorm.2016.12.001 ◽

2016 ◽

Vol 5 ◽

pp. 7-12 ◽

Cited By ~ 2

Author(s):

Pedro Ramos ◽

Eloisa Bonfá ◽

Patrícia Goulart ◽

Marion Medeiros ◽

Nélson Cruz ◽

...

Keyword(s):

Operating Room ◽

Six Sigma ◽

Medical Center ◽

Academic Medical Center ◽

Lean Six Sigma ◽

First Case ◽

Academic Medical

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Optimizing nursing time in a day care unit: Quality improvement using Lean Six Sigma methodology

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzz087 ◽

2019 ◽

Cited By ~ 1

Author(s):

Carmel Davies ◽

Caroline Lyons ◽

Regina Whyte

Keyword(s):

Quality Improvement ◽

Six Sigma ◽

Day Care ◽

Private Hospital ◽

Positive Impact ◽

Value Added ◽

Lean Six Sigma ◽

Added Value ◽

Staff Satisfaction ◽

Nursing Time

Abstract Objective This study applies Lean Six Sigma (LSS) to improve the efficiency of a private hospital day care unit and generate a positive impact on optimizing nursing time and improving personalized patient care and staff satisfaction. Design A prospective interventional study using pre- and post-evaluation. Setting A day care unit at a private hospital. Participants Nurses and patients from the day unit. Intervention(s) Define, Measure, Analyze, Improve and Control was used as an overarching problem-solving framework. All front line staff, clinical leaders and managers were supported as active change agents in the quality improvement (QI) initiative. Multiple interventions were adopted across the service that aimed to de-implement non-value added activities and enhance processes with activities that added value. Main outcome measures Patient turnaround times (PTTs), nursing time, nurse-patient ratio, nurse and patient survey. Results A post-implementation evaluation highlighted significant improvements in service performance and patient and staff satisfaction. Significant added value includes a reduction in PTTs, an increase in nursing care time and improvement in the nurse-patient ratio. Conclusion This project identified that utilizing LSS that relies on collaborative team effort is effective in creating a positive organizational culture for improvement and change. The Six Sigma tools and techniques provide evidence-based approaches that support QI in practice.

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Using Lean Six Sigma to Decrease Delivery Time of Blood Products to the Operating Room

A & A Practice ◽

10.1213/xaa.0000000000001463 ◽

2021 ◽

Vol 15 (5) ◽

pp. e01463

Author(s):

Samantha H. Garvanovic ◽

Jason W. Gatling ◽

Annie T. Wang ◽

Christine M. Wong ◽

Wesley T. Stevens ◽

...

Keyword(s):

Operating Room ◽

Six Sigma ◽

Lean Six Sigma ◽

Delivery Time ◽

Blood Products

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Critical success factors for lean six sigma in quality 4.0

International Journal of Quality and Service Sciences ◽

10.1108/ijqss-06-2020-0099 ◽

2021 ◽

Vol 13 (1) ◽

pp. 123-156 ◽

Cited By ~ 1

Author(s):

Neeraj Yadav ◽

Ravi Shankar ◽

Surya Prakash Singh

Keyword(s):

Six Sigma ◽

Industry 4.0 ◽

Critical Success Factors ◽

Success Factors ◽

Lean Six Sigma ◽

Related Factors ◽

Seamless Integration ◽

Content Type ◽

Critical Success ◽

Set Up

Purpose Critical success factors (CSF) for lean six sigma (LSS) using quality 4.0 are not researched so far. This study aims to bridge this gap. It also validates CSF already identified for LSS under conventional technologies. Design methodology approach Empirical research using the questionnaire method is conducted. Construct of the questionnaire is checked using Cronbach’s alpha and responses received are analysed using t-test and exploratory factor analysis. Findings In total, 20 factors are evaluated for LSS success. It includes 7 factors related to quality 4.0 technologies and 13 related to the conventional set-up. All 7 quality 4.0 related factors were found critical; whereas, under traditional set-up, 11 factors out of 13 were found critical. Practical implications The study will help enterprises in the fast and effective adoption of quality 4.0 and seamless integration with LSS. The post-Covid-19 business scenario is expected to be information technology focussed. The findings of this study will be useful in these circumstances. Consultants and practitioners can prioritise their efforts based on newly identified CSF. The new revelation about CSF for LSS in quality 4.0 enriches theory as well. Social implications Developing skills based on newly identified CSF will help people in remaining employable in the era of automation, robotics and artificial intelligence which is otherwise ill-famed for destroying jobs. Originality value CSF for LSS using quality 4.0 is a new contribution. It differentiates CSF established earlier for conventional technologies. Moreover, many CSF are common for LSS and industry 4.0, therefore this study will also help in smoother adoption of industry 4.0/quality 4.0 in organisations.

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