Lean Six Sigma Applied to Ultrasound Guided Needle Biopsy in the Head and Neck

Matt, Bruce H.; Woodward-Hagg, Heather; Wade, Christopher L.; Butler, Penny D.; Kokoska, Mimi S.

doi:10.1177/0194599814528659

Cited by 19 publications

(11 citation statements)

References 22 publications

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“…18,19 Increasing the efficiency of hospital-based clinical care by applying LH was identified as a potent strategy for lowering costs and improving outcomes. 20 Some areas where LH has been implemented include: intensive care units (ICUs), 21 cardiology, 22 surgery, 23 gynecologic oncology, 24 colonoscopy, 25 pathology, 26 radiology, 27 mental health units, 28 eye hospitals, 29 otolaryngology, 30 ultrasound-otolaryngology, 31 organ transplant centers, 32 and clinical laboratories, 33 to name but a few. In the United States, a national survey found that around 70% of hospitals use LH or related approaches.…”

Section: Introductionmentioning

confidence: 99%

Effects of Lean Healthcare on Patient Flow: A Systematic Review

et al. 2020

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Objectives: To assess the effects of lean healthcare (LH) on patient flow in ambulatory care and determine whether waiting time and length of stay (LOS) decrease after LH interventions. Methods: A systematic review was performed with close adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched for studies of healthcare organizations applying LH interventions within ambulatory care published between 2002 and 2018. Six databases and grey literature sources were used. Two reviewers independently screened and assessed each study. When consensus was difficult to reach, a third reviewer intervened. Finally, a summary of findings was generated. Results: Out of 5627 studies, 40 were included. Regarding LOS for all patients, 19 out of 22 studies reported a decrease. LOS for discharged patients decreased in 11 out of 13 studies, whereas LOS for admitted patients was reduced in 6 out of 7 studies. Waiting time for patients before seeing a healthcare professional decreased in 24 out of 26 studies. Waiting time to treatment and waiting time for appointments were minimized in 4 and 2 studies, respectively. Patients who left without being seen by a doctor decreased in 9 out of 12 studies. Finally, patient and staff satisfaction were measured in 8 and 2 studies, respectively, with each reporting improvements. Conclusions: According to our findings, LH helped to reduce waiting time and LOS in ambulatory care, mainly owing to its focus on identifying and minimizing non-value added (NVA) activities. Nevertheless, evidence of the impact of LH on patient/ staff satisfaction and the translation of the obtained benefits into savings is scarce among studies.

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Section: Introductionmentioning

confidence: 99%

Effects of Lean Healthcare on Patient Flow: A Systematic Review

et al. 2020

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“…Our literature search in PubMed identified 31 articles studying the application of Lean management to improve patient flow in an outpatient clinic setting. Matt et al 13 previously reported the value of Lean strategies to reduce cost, time to diagnosis, and improve office‐based FNA workflow process. However, to our knowledge, this is the first study to apply Lean principles along with unsophisticated, open‐source technology such as Google Drive, iOS apps, and barcodes to develop a customized, cost‐effective inventory management system for maximizing FNA clinic workflow.…”

Section: Discussionmentioning

confidence: 99%

Building a smart FNA cart: When Google meets cytology

Haghighi

Nair

Mashiana

et al. 2020

Cancer Cytopathology

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BACKGROUND: The appropriate management of a fine needle aspiration (FNA) supply cart and equipment set up is essential to ensure the smooth and optimal operation of a busy FNA clinic. We applied Lean strategies such as value stream mapping (VSM), the 5S method (Sort, Set in order, Shine, Standardize, Sustain), and Kanban to remove waste and improve patient flow in an FNA clinic. METHODS: The workflow analysis suggested that existent problems such as suboptimal inventory management and unavailability of standard operating procedures (SOPs) caused a 10% to 85% increase in total procedure time. To improve inventory management, we created a 2-bin Kanban system. We used the "Scan to Web" app and a Google Drive form to create a cost-effective electronic inventory management system. We distributed the essential SOPs in the format of video clips using our YouTube channel and leveraged barcode technology to access the links. RESULTS: Upon completion of our process improvement project, we succeeded to eliminate the stock-out events and maintain a process cycle efficiency of 87%. The 5S audit checklist result increased from 6% to 100% implementation, which is consistent with focused improvement. The developed inventory system enabled us to track the supply usage, forecast demands, and improve the accuracy of orders. CONCLUSIONS: Lean methods such as VSM, 5S, and Kanban combined with open source technologies can be implemented to ensure material availability, track inventory, and provide immediate access to SOPs on demand. The developed system also led to increased efficiency and improved flow, as well as responsiveness to changes in

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“…Matt et al demonstrated that office‐based biopsies of head and neck masses decreased time to diagnosis, patient travel, and unnecessary laboratory and imaging studies. This enhanced patient convenience and staff satisfaction while reducing costs and risks associated with diagnosis . Collar et al instituted automated paging and enhanced paperwork availability to streamline perioperative processes, effectively reducing unutilized operating room (OR) time .…”

Section: Introductionmentioning

confidence: 99%