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 Surgical Services

Using lean methods to improve OR turnover times 

The article describes the application of lean methods to improve OR turnover times. Key to the approach is differentiating turnover requirements by surgical specialty and developing standard work in a job breakdown structure for individual roles in the process. This approach can be applied to other healthcare processes where consistent performance is necessary for safe patient care and improving cycle times.

Complexities in the operating room - Focus on OR turnover times

Identifying the areas of improvement in an effort to reduce operation room turnaround time and the inaccuracy of surgery scheduling is explored through case study examples including first person observations from the University of Pittsburgh industrial engineering case study at UPMC Presbyterian and Montefiore Surgery Departments. This article was previously published in the proceedings of the 2012 Industrial and Systems Engineering Research Conference. 

Evaluating the financial viability of particular operative procedures using TDABC - 2013 Healthcare Systems Process Improvement Conference presentation

To improve revenues, the Sir Mortimer B. Davis Jewish General Hospital needed to determine the financial viability of particular surgical procedures. This presentation discusses how the hospital used TDABC to determine costs, utilization, and potential process improvements for cataract surgeries to determine whether it should do more or less of them. The approach can be applied to other surgical specialties to identify areas of opportunities and priorities.

Driving value through clinical practice variation reduction: A case study for total joint replacement process improvement

This paper and presentation delivered at the 2013 Healthcare Systems Process Improvement Conference describes work done in the Ochsner Health System to reduce orthopedic joint replacement costs and improve quality for the patient. High quality care at an affordable cost is an attainable goal that is both in the best interest of the patient and the healthcare system. Driving value through minimization of clinical variation enabled OHS to meet a higher standard of patient care while ensuring the long-term financial stability of the organization.

Effective use of simulation in scenario development for relocation planning

This presentation was originally delivered at the Society for Health System's 2013 Healthcare Systems Process Improvement Conference in New Orleans. Shands Healthcare's Management Engineering was asked to model the impact to resource utilization of the Pre-Op/PACU/OR area resulting from relocating the current GI/ENDO procedure suites from North to South Tower. A dynamic simulation model was developed as the most effective and timely method to model the current operational state plus three future growth scenarios.

Applying science and strategy to operating room workforce management

This article in Medscape Today describes an approach at Cleveland Clinic to improving management of the operating room workforce. It provides some interesting reference values for average staffing per room, skill mix and in-room staff utilization percentages.

Behind the scenes of inventory management: A generalized approach

This presentation at the 2013 Healthcare Systems Process Improvement Conference is focused on describing a generalized strategy for improving inventory management using communication, spatial layout, and physical organization, standardization of process and inventory par levels. In healthcare settings, particularly surgery, creating or establishing this standard requires a complete system perspective of inventory.

Surviving the global healthcare perfect storm

The authors describe the application of operational planning and capacity management methods to improve patient care, improve revenue, and lower costs. Article 

Tools for Improvement - Education in operating room management 

The University of Iowa has a public access website that provides lecture slides for a comprehensive OR Management course offered by the Carver College of Medicine. Readers may contact the University of Iowa for more information about the course or Web conferencing options.

Original films of Frank B. Gilbreth 

Part 1 & Part 2
From Internet Archive website, these films are essentially a summary of work analysis films which were taken by Frank B. Gilbreth between 1910 and 1924 showing a number of industrial operations from which the motion study technique was developed.
This movie is part of the collection: Prelinger Archives.
Producer: Presented by James S. Perkins in collaboration with Dr. Lillian M. Gilbreth & Dr. Ralph M. Barnes
Sponsor: Chicago Chapter of the Society for the Advancement of Management

Total productive maintenance in the OR - A case study at Kadlec Regional Medical Center

A team at Kadlec Regional Medical Center in Richland, Wash., took a lean approach to improving the availability and reliability of anesthesia related equipment in the OR. The team included physicians, staff, and external consultants. The article describes the background of total productive maintenance and how it was applied by a multidisciplinary team including physicians, OR staff, and clinical engineering. View related photos 

Purdue industrial engineering researchers investigate using surgeon hand gestures to improve surgery 

Vision based recognition of hand gestures is being researched at Purdue University to control a robotic scrub nurse and access images during surgical cases. The research could lead to short case lengths and reduced infections according to the Purdue University News website.

Helping a hospital shine

In an article previously published in Industrial Engineer magazine, industrial engineering researchers at Clemson University assisted Cannon Memorial Hospital in Pickens, S.C., in a number of hospital-wide and service specific improvements resulting in increased efficiency.

The art of implementing Lean from AORN Management Connections

A recent article in AORN Management Connections by Carina Stanton describes how three healthcare organizations are implementing lean.

Adding value to the surgical PAT process

Using Lean Six Sigma tools, a hospital redesigns its PAT department process so that all charting is completed 72 hours prior to the day of surgery.

Pioneers of Industrial Engineering and Health Care : Part 1

This article profiles Frank Gilbreth and Henry Ford.  Gilbreth initiated the study of time and motion in the OR, and Ford was the first to attempt to decrease wasted motion among nursing staff.

SHS Helping a Hospital Shine

Lean tools are used to redesign processes throughout a hospital.

SHS Paging Dr Toyota

Discussion of applications of lean within the OR.

SHS Attacking Waste and Variation Hospital-Wide: A Comprehensive Lean Sigma Deployment

Improvement projects in surgery, nursing, and the ED are discussed.  The process of moving a hospital towards adoption of Lean Six Sigma is also described.

SHS Using Lean Methodology to Improve Patient Safety and Clinical Quality

Three successful lean projects are discussed in detail.  Specimen Labeling, Surgery and Endoscopy Pre-Op, and Inpatient Nursing Crash Cart projects all demonstrate significant improvement.

SHS Putting Data Into Action in the Operating Room Setting

New ways to display OR data are proposed in this presentation.

SHS Optimization of Surgical Scheduling

An OR's case scheduling process is studied; improvement projects are proposed.

SHS Improving Patient Care - Case Carts and the Operating Room

Reasons for delay in creation of case carts are addressed.  SPD often has inefficient workarounds as part of their daily routine.

SHS Continued Barriers to Operational and Financial Performance in Surgical Services

Surgical services projects often have many barriers to success; this presentation helps illuminate and identify where they may be for your hospital.

SHS Streamlining Your OR

A hospital undertakes a systemic improvement of their OR suite.  The process and final results are detailed.

SHS Optimization of Overtime Costs and Operating Room Utilization

A program is proposed that effectively confronts a majority of the issues with scheduling patient surgeries.

SHS Our Lean Journey Continues and What A Year It's Been!

Lean projects at Kaiser Permanente are detailed and discussed. The report is a system-level presentation showing many departmental improvements.

SHS Reducing Inventory Waste Through Material Pull

A pull system is implemented within a surgical suite, saving on inventory cost. Other accomplishments and lessons learned are discussed.

SHS Using Lean Techniques to Improve Turnaround Time and First Case Starts in the Operating Room

Turnarounds and first case starts are improved using a variety of lean techniques. Sustainability, achievement of buy-in and metric details are also discussed.

SHS Improving Surgical Services Through Enhanced Ancillary Support

Lean improvement projects are performed within the supplies delivery function of a surgical services suite.



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