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Improving Operating Room Efficiency Using Lean in an Academic Medical Center
Romina Deldar, BS; Tahereh Solemani, MD, MPH; Carol Harmon, RN: Larry Stevens, MD; Michael W. Chu, MD
Indiana University School of Medicine
2016-01-31
Presenter: Romina Deldar
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: Dr. Rajiv Sood
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Improving operating room (OR) efficiency is increasingly important. Lean was developed in the manufacture industry and its methods were applied at a high volume, academic medical center. The purpose of this study was to analyze causes and characteristics of late start cases.
Methods: A retrospective review was performed on all outpatient surgeries from January – December 2015. Lean was implemented in May and a cohort of pre-Lean was used to compare post-Lean surgery start times. The etiology of late starts, surgeon and
anesthesia providers, surgical service, and temporal effects were analyzed.
The pre-LEAN group was compared to the post-LEAN group using bivariate analysis, and statistical significance was set at p <0.05.
Results: A total of 514 pre-Lean and 2,437 post-LEAN surgeries were identified. A significantly higher proportion of cases in the post-Lean group had on-time starts compared to the pre-Lean group, (52.4% vs 69.0%, p<0.01). The average delay for all late-start cases was 16.3 minutes. Pre-Lean average delay was 18.3 minutes and was reduced to 15.7 minutes post-Lean (p=0.01). The delay per case pre-Lean was 8.1 minutes and 4.5 minutes post-Lean. The etiology of delay in the post-Lean group was less likely to be due to anesthesia, surgeon, OR, or patient assessment (71.1% vs 79.8%, p=0.04).
Conclusion: Use of Lean techniques increased OR efficiency and were statistically significant in decreasing late starts. Preparing the OR the night before, limiting the number of family and visitors, and improving personnel workflow was effective and applicable for all surgical specialties.
