lean operations
Abstract
Hospital operating rooms are experiencing higher costs and less available capacity, yet they typically generate the highest returns of all hospital departments. In the case study described in this paper, a process improvement team in a hospital Operating Room Department at aimed to address these issues by decreasing the turnaround time between surgical cases and increasing the percentage of first cases of the day beginning at their scheduled time. These two performance metrics were targeted for improvement through the use of lean work system principles implemented by a cross-functional process improvement team of OR employees aided by external consultants. This systematic improvement project resulted in significant improvement in on-time first case starts and slight overall improvement in turnaround time by the time the formal process improvement project concluded. This paper summarizes the overall approach used by the team, key tools applied and associated findings, results for performance metrics, and potential future improvements.
Keywords
Lean, process improvement, operating room, 5S
1. Introduction and Background
Montgomery Regional Hospital, or MRH, is a hospital within the Hospital Corporation of America – Capital Division (HCA), an investment-based healthcare institution. The 60 full-time employees in the MRH Operating Room Department (MRH-OR) handle over 6,500 surgical and endoscopy cases per year across six Operating Rooms and two Endoscopy Rooms. At the time this improvement project began, the MRH-OR operated at approximately 70% capacity. Although operating in an aging facility with limited storage and organizational space, hospital leadership recognized the potential for improvement, particularly the opportunity to increase OR capacity, thus enabling physicians to schedule more surgical cases. In order to realize this longer-term goal, turnaround time and first case start were targeted for improvement. Because of the cost of OR
Hospital operating rooms are experiencing higher costs and less available capacity, yet they typically generate the highest returns of all hospital departments. In the case study described in this paper, a process improvement team in a hospital Operating Room Department at aimed to address these issues by decreasing the turnaround time between surgical cases and increasing the percentage of first cases of the day beginning at their scheduled time. These two performance metrics were targeted for improvement through the use of lean work system principles implemented by a cross-functional process improvement team of OR employees aided by external consultants. This systematic improvement project resulted in significant improvement in on-time first case starts and slight overall improvement in turnaround time by the time the formal process improvement project concluded. This paper summarizes the overall approach used by the team, key tools applied and associated findings, results for performance metrics, and potential future improvements.
Keywords
Lean, process improvement, operating room, 5S
1. Introduction and Background
Montgomery Regional Hospital, or MRH, is a hospital within the Hospital Corporation of America – Capital Division (HCA), an investment-based healthcare institution. The 60 full-time employees in the MRH Operating Room Department (MRH-OR) handle over 6,500 surgical and endoscopy cases per year across six Operating Rooms and two Endoscopy Rooms. At the time this improvement project began, the MRH-OR operated at approximately 70% capacity. Although operating in an aging facility with limited storage and organizational space, hospital leadership recognized the potential for improvement, particularly the opportunity to increase OR capacity, thus enabling physicians to schedule more surgical cases. In order to realize this longer-term goal, turnaround time and first case start were targeted for improvement. Because of the cost of OR