Increasing Operating Room Utilization Through Implementation of Lean and
Six Sigma Principles: A Literature Review
Abstract
Rationale, aims, and objectives: Lean and Six Sigma methodologies are
set of principles aimed at improving organizations through restructuring
processes, and via identification and elimination of steps that do not
add value for the consumer and result in wasted time, resources and
expenses. Owing to its multifaceted nature and high impact on patient
health and recovery, as well as its significant financial impact, the
operating room (OR) environment is an obvious substrate for Lean and Six
Sigma implementation. In this review, we aim to prioritize the most
effective and reproducible optimization Lean and Six Sigma tool and to
raise awareness among healthcare professionals about the current
experience of Lean and Six Sigma utilization in the daily work routine
in the OR. Methods: A computerized search from inception up to June 2019
of the online electronic databases PubMed and Google Scholar was
performed. Studies investigating Lean or Six Sigma interventions
considering various OR aspects were examined. Results: Most of the
studies originated in the USA and demonstrated Value Stream Mapping
(VSM) as the most common practiced optimization technique followed by
the Define, Measure, Analyze, Improve, Control (DMAIC) tool. These
methods provided the most effective sole tools for promoting positive
changes in the work environment. Conclusions: Lean and Six Sigma
implementation in the OR was found to be associated with improved safety
and quality of care, reduced waiting times, increased patient
satisfaction and cost reduction. We suggest that the implementation of a
synergized approach, combining VSM and DMAIC tools, in the routine
workflow may lead to a positive impact on productivity and efficiency,
regardless of the scale or type of surgical procedures performed.