Improving healthcare and operating room efficiency using lean six sigma

Abstract

Wait times and availability of care are major issues within Manitoba’s healthcare system and to improve in these areas a new method for improvement is needed. The purpose of this research is to prove the efficacy of using Lean Six Sigma in healthcare to generate improvements and to promote the usage of continuous improvement methodologies in the healthcare environment. To demonstrate the effectiveness of using Lean Six Sigma, a project was completed at St. Boniface Hospital to reduce overtime in operating rooms. Lean Six Sigma was used to assess the entire system and identify multiple areas for improvement, with case duration estimates being found to have the most potential for reducing overtime. This resulted in predictive models being created and tested against the current method of surgeon estimates. All models improved on the surgeon estimates (45-63% increase in on-time cases, reduction in overtime error by 49-59%, and 71-89% improvement in overtime to undertime error ratio) and it is recommended that a predictive modeling approach be used in the future. The Lean Six Sigma project was successful and also resulted in multiple additional beneficial outcomes: identification of other areas needing improvement, ranked by potential impact; process analysis and mapping which can be used in future projects; and identification of other causes for error in scheduling. In addition, if Lean Six Sigma had not been used, the project would have focused on a less impactful area—first case on-time starts. As Lean Six Sigma is a data-driven process, the impact of bias was removed and thus it was found that first case on-time starts were not as influential to overtime as assumed. From this research, it can be concluded that Lean Six Sigma can be effectively applied in even the most complex of hospital environments. It is recommended that hospitals consider implementing experienced teams to lead and train hospital employees in Lean Six Sigma or other continuous improvement methods.