Perfecting Patient Flow in the Surgical Setting

Abstract

Reduced surgical efficiency and productivity, delayed patient discharges, and prolonged use of hospital resources are the results of an OR that is unable to move patients to the postanesthesia care unit or other patient units. A primary reason for perioperative patient flow delay is the lack of hospital beds to accommodate surgical patients, which consequently causes backups of patients currently in the surgical suite. In one facility, implementing Six Sigma methodology helped to improve OR patient flow by identifying ways that frontline staff members could work more intelligently and more efficiently, and with less stress to streamline workflow and eliminate redundancy and waste in ways that did not necessitate reducing the number of employees. The results were improved employee morale, job satisfaction and safety, and an enhanced patient experience.

Implementation and Analysis of a Lean Six Sigma Program in Microsurgery to Improve Operative Throughput in Perforator Flap Breast Reconstruction

“…[1][2][3][4] For perforator flap breast reconstruction, intraoperative pathways can lead to improvements in operative time, cost, quality measures, and staff satisfaction, but such success is dependent on developing a team-based model of health care delivery, which must focus on interdisciplinary communication, enhanced efficiency through standardization of practice, and eliminating unnecessary steps, especially for lengthy procedures.…”

Improving hospital patient flow: a systematic review

“…In the surgical setting, a set of integrated recommendations (i.e. anticipated discharge date, notifying family members of the discharge time and defining standard discharge responsibilities for key individuals) involving the Operating Room, the Intensive Care Unit and Surgical Care Units improved the admission and discharge process (Williams et al , 2011; Amato-Vealey et al , 2012).…”

“…The effectiveness of multi-professional teams to improve patient flow and clinical outcomes has been tested by several studies (Alikhan et al , 2009; Amato-Vealey et al , 2012; Borenstein et al , 2016; Chadaga et al , 2012; Dickson et al , 2009; Elliot et al , 2015; Evans et al , 2011; Healy-Rodriguez et al , 2014; Jweinat et al , 2013; Lovett et al , 2014; Muntlin Athlin et al , 2013; Odom et al , 2018; Ortiga et al , 2012; Sánchez et al , 2018; Yancer et al , 2006). Some examples include the development of a Hospital Medicine ED Team consisting of hospital medicine physicians, ED physicians, social workers and nurses (Chadaga et al , 2012); the development of a multi-professional team responsible for the whole care process for a group of patients (Muntlin Athlin et al , 2013); the incorporating of one logistic manager and two registered nurses in a logistics management program (Healy-Rodriguez et al , 2014).…”

Detecting performance variance in complex surgical procedures: analysis of a step-wise technique for laparoscopic right hepatectomy

“…According to several authors, a coordinated multidisciplinary process redesign involving anesthesiologists, surgeons, and nurses are key to improving OR productivity, lowering OR turnover time, and anesthesia-related time. [14][15][16][17][18][19] Some authors have demonstrated that introducing these manufacturing industry tools to surgical practice are objective methods for detecting variances and identifying areas for implementing changes. 13,14 In surgery, LM focuses on reducing waste in a process, and SS reduces process variation through the application of statistical methods.…”