Abstract

Background: Unsatisfied staff at the orthopedic surgery department have been staying after hours at the hospital and complaining about the lengthy waiting and turnover times in the operating room (OR), these waiting times between two procedures were on average of 60 minutes per surgeon per surgery, meaning that the daily accumulated waiting times were over 240 minutes per surgeon, which causes them to stay overtime and have lengthy working days and shifts. The estimated calculated cost in the OR is approximately $105/ minute.
Methods: A team was created to tackle this problem using the six sigma methodology.
Intervention: The team chose the solution of making the OR only for surgery and pulling out the anesthesia step by administering the nerve block outside the OR. The hospital went through a recent renovation and redesign and constructed new nerve block rooms that became the new sites of administering the nerve blocks.
Results: At start the team was looking at a 50% time reduction of the surgeon’s waiting times to 30 minutes. After implementing the new process, the waiting times were cut down to an average of 18 minutes, which is a 70% reduction in turnaround time.
The value added as result of this project is saving up time, thus happier staff, the ability of adding one more orthopedic surgery per physician each day at the hospital, meaning to two more surgeries would add at least $8000 per day as added revenue for the hospital, and two more patients off the waiting list.

Key words: Quality improvement, Process improvement, Surgery Six sigma, project, DMAIC improvement model, Patient experience