Charles Coffey1, Edward S Cho2, Eric Wei3, Allison Luu1, Maria Ho3, Rodolfo Amaya4, Marie Pecson5, Florence V Dalton5, Deborah Kahaku5, Brad Spellberg3, Stephen F Sener6. 1. Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, USA; Department of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA. 2. Keck School of Medicine of University of Southern California, Los Angeles, CA, USA. 3. Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, USA; Department of Emergency Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA. 4. Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, USA; Department of Anesthesiology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA. 5. Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, USA. 6. Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA. Electronic address: stephen.sener@med.usc.edu.
Abstract
BACKGROUND: Delays in first cases contribute to multiple operating room (OR) inefficiencies and decreases in OR productivity. METHODS: 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. RESULTS: 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 < 0.0000001). CONCLUSIONS: Implementation of lean interventions in the pre-operative holding area was associated with significantly improved rates of elective first case on-time starts.
BACKGROUND: Delays in first cases contribute to multiple operating room (OR) inefficiencies and decreases in OR productivity. METHODS: 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. RESULTS: 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 < 0.0000001). CONCLUSIONS: Implementation of lean interventions in the pre-operative holding area was associated with significantly improved rates of elective first case on-time starts.
Authors: Divya L Raman; Elise C Bixby; Kevin Wang; Danielle Rossi; Jennifer Ringler; Danielle A Wiggins; Sushrut Arora; Jema Delfin; SarahJane Guida; Lisa McLeod; Michael G Vitale Journal: J Pediatr Orthop Date: 2022-03-01 Impact factor: 2.324
Authors: Anita A Vashi; Barbara Lerner; Tracy H Urech; Steven M Asch; Martin P Charns Journal: BMC Health Serv Res Date: 2019-02-04 Impact factor: 2.655
Authors: Scott M Pappada; Thomas J Papadimos; Sadik Khuder; Sean T Mack; Peyton Z Beachy; Andrew B Casabianca Journal: Anesthesiol Res Pract Date: 2022-09-13