Improving Operating Room Turnover Time in a New York City Academic Hospital via Lean

Cerfolio, Robert J.; Ferrari-Light, Dana; Ren-Fielding, Christine; Fielding, George; Perry, Nissa; Rabinovich, Annette C.; Saraceni, Mark; Fitzpatrick, Maureen; Jain, Sudheer; Pachter, H. Leon

doi:10.1016/j.athoracsur.2018.11.071

Cited by 70 publications

(62 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Remarkably, all studies reporting an improvement in either OTS, TOT, or TAT, used multidisciplinary teams during the intervention. Other factors that might affect the perioperative process, include patient-related variables, personnel unavailability [ 117 ], surgeon variables [ 24 , 118 ], the workflow in the anesthesia preparation tasks [ 22 , 101 , 103 ], the type of the previous operative case (emergency), the waiting time for trays or patients arriving late [ 119 ], if a scheduled gap existed between the cases [ 21 ], patient family and social support [ 109 ], and even the weather [ 109 ].…”

Section: Discussionmentioning

confidence: 99%

“…Operating rooms are linked to significant costs in most hospitals [ 147 ] but are potentially the most lucrative part of many healthcare systems [ 103 ]. With surgical care representing about a third of all healthcare spending [ 148 ], and with healthcare costs continuing to rise [ 149 , 150 ], healthcare enterprises are focusing on eliminating inpatient operational inefficiencies and waste to reduce unnecessary costs [ 93 ].…”

Section: Discussionmentioning

confidence: 99%

“…Naturally, to fully realize the potential benefits of LH, organizations need to minimize the impact of such barriers and capitalize on facilitating conditions that are specific to their local contexts [ 134 ]. Once institutional rules and dogma are changed, culture and workflow improve [ 103 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

Zepeda-Lugo

Tlapa

Báez-López

et al. 2020

IJERPH

View full text Add to dashboard Cite

Healthcare services are facing challenges in increasing their efficiency, quality of care, and coping with surges in demand. To this end, some hospitals have implemented lean healthcare. The aim of this systematic review is to evaluate the effects of lean healthcare (LH) interventions on inpatient care and determine whether patient flow and efficiency outcomes improve. The review was performed according to PRISMA. We used six databases to search for studies published from 2002 to 2019. Out of 5732 studies, 39 measuring one or more defined outcomes were included. Hospital length of stay (LOS) was measured in 23 studies, 16 of which reported a reduction, turnover time (TOT) decreased in six out of eight studies, while the turnaround time (TAT) and on-time starts (OTS) improved in all five and seven studies, respectively. Moreover, eight out of nine studies reported an earlier discharge time, and the boarding time decreased in all four cases. Meanwhile, the readmission rate did not increase in all nine studies. Lastly, staff and patient satisfaction improved in all eight studies. Our findings show that by focusing on reducing non-value-added activities, LH contributed to improving patient flow and efficiency within inpatient care.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

Zepeda-Lugo

Tlapa

Báez-López

et al. 2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…Perioperative leaders should consider surgical team familiarity as a potential adjunct to reduce inefficiencies and variances in surgical care and lower costs. Previous researchers determined that the average cost of one minute of OR time ranges from $36 41 to $150 42 depending on location and setting. Although there are limited data available on the effectiveness of dedicated surgical teams and cost savings, Flynn et al 40 identified significant cost savings ( P < .001) of $6,000 to $8,900 per pediatric spine procedure.…”

Section: Discussionmentioning

confidence: 99%

Surgical Team Familiarity: An Integrative Review

Stucky¹,

Jong²

2020

AORN Journal

View full text Add to dashboard Cite

The dynamic nature of perioperative care often brings unfamiliar clinicians together yet requires them to collectively provide complex health care in a challenging environment. In this review, we comprehensively evaluated evidence regarding surgical team familiarity and its relationship to surgical team performance. Using a comprehensive and iterative search strategy, we searched PubMed, Web of Science, PsycInfo, and EMBASE for surgical team familiarity manuscripts. We identified 598 manuscripts, 16 of which met our inclusion criteria. We found that surgical team familiarity is associated with improved performance for many metrics, including shorter total operative time, team member safety, decreased surgical errors and disruptions, reduced miscommunication, and fewer patient readmissions. Although additional research would be helpful, surgical managers should consider team familiarity and consistency in team membership when assigning staff members to surgical teams to optimize surgical care, decrease inefficiencies, and promote safe patient outcomes.

show abstract

“… 5 Value Stream Map, TAKT time, Kanban, Seven Wastes, Visual Management and 5S are some of the common lean analysis and improvement tools, which have been applied to the medical industry in recent years. 6 - 8 Both Lean and Six Sigma are activities designed to implement continuous improvement, emphasizing customer satisfaction and system integration. The starting point of Six Sigma is to reduce variation, and the core of lean production is to eliminate all unnecessary wastes, but the process of eliminating variation itself is to reduce waste.…”

Section: Introductionmentioning

confidence: 99%

Applying Lean Six Sigma to Reduce the Incidence of Unplanned Surgery Cancellation at a Large Comprehensive Tertiary Hospital in China

Zhu

Qian

Zhou

et al. 2020

INQUIRY

View full text Add to dashboard Cite

Unplanned surgery cancellation (USC) was an important quality management issue in the course of medical care for surgical patients, which caused inappropriate use of hospital resources and had negative impacts on quality and safety. This study used Lean Six Sigma to reduce the incidence of USC. Following the Lean Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) process, the main factors influencing the USC were identified, such as the time of informing patient admission, the time of submitting operation notice, and the management of test report follow-up. A series of measures were implemented including improving the health education content of virtual bed patients, standardizing the way of communication between the Admission Management Center and the patients, improving the timing of anesthesia evaluation, optimizing the process of operation notice with an information system, and implementing the regulations of virtual bed management. The incidence of USC reduced from 10.21% in Jan. 2016 to 3.8% in Dec. 2016, and the Z-score increased from 1.25 to 1.68, which improved patient safety and demonstrated that Lean Six Sigma was an effective method to solve cross-department issues in hospital.

show abstract

Improving Operating Room Turnover Time in a New York City Academic Hospital via Lean

Cited by 70 publications

References 15 publications

Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

Surgical Team Familiarity: An Integrative Review

Applying Lean Six Sigma to Reduce the Incidence of Unplanned Surgery Cancellation at a Large Comprehensive Tertiary Hospital in China

Contact Info

Product

Resources

About