Using Lean Six Sigma to Redesign the Supply Chain to the Operating Room Department of a Private Hospital to Reduce Associated Costs and Release Nursing Time to Care
Abstract
:1. Introduction
2. Materials and Methods
- Standardisation of stock handling over the sterile area redline,
- A reduction in the value of stock going out of date by a minimum of 50%,
- Providing POU stock to avoid out-of-stock situations,
- Creation of dedicated storage areas by surgical and anaesthesia specialty in the main OR stores,
- Remove non-value-added (NVA) activity for nursing staff and release time to care,
- Development of a proof of concept in a pilot OR suite to roll out to the other OR suites, and
2.1. Define
- A duration of 30 min working alongside individual OR nurses [n = 12] and procurement staff [n = 2] opportunistically (interviewing OR nurses as they dealt with supply and stock for surgical cases).
- 2.
- 40 min meetings with OR managers [n = 8], co-ordinators [n = 4] and OR procurement staff [n = 2]. These interviews were semi-structured and facilitated an interview format that allowed pre-determined topics to be covered (waste, health, and safety, space, and layout) that had been found in the 30 min interviews; however, it also afforded the flexibility to discuss individual participant’s experiences in more detail [40].
- Nursing time to prepare stock for cases,
- End of year stocktake, and
- Value of location of stock within the pilot OR (OR 6).
2.2. Measure
2.3. Analyse
2.4. Improve
3. Results
3.1. Reduction in Stock Holding Value
3.2. Reduction in OR Nursing Stock Prep Time
3.3. Reduction in Value of Stock Going out of Date
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Improvement Tool | Description | Reference Number |
---|---|---|
Project Charter | A project charter defines the problem statement and attains baseline data for the project. Used to identify goals of the project and what is in scope | [32] |
SMART Goals Specific, Measurable, Achievable, Relevant, and Timebound | SMART is used to manage the project goals, to determine if they are Specific, Measurable, Achievable, Relevant and Timebound | [32] |
SIPOC Suppliers, Inputs, Process, Outputs, and Customers | A high-level SIPOC (Supplier, Input, Process, Output, and Customer) highlights the process steps and defines the customers and stakeholders | [33] |
RACI Responsible, Accountable, Consulted Informed | Identifies which stakeholders are responsible, accountable, which need to be kept informed or consulted | [32] |
CTQ Critical To Quality | The CTQ is designed to capture the key measurable characteristics of a process or service whose performance standards must be met to satisfy the service user | [34] |
VOC Voice of the Customer | Engaging with the customer to gather their feedback about their experiences with and expectations for your products or services | [1,2,35] |
Gemba | Observation of the actual process taking place | [36] |
Fishbone | Identifies root causes, representing the effect and the factors or causes influencing it | [32] |
5S | A system to reduce waste and optimise productivity through maintaining an orderly workplace and using visual cues. A cyclical methodology of ‘Sort, Set in Order, Shine, Standardise and Sustain the Cycle’ | [37] |
Standardisation for Stock Handling—Solutions | |
---|---|
A 5S process carried out in OR stock room—visual management | Relocation of the OR red-line demarcating sterile areas to facilitate stock management |
A 5S process carried out in OR 6—visual management | Introduction of returns baskets to facilitate stock management post-surgical case list |
Implementation of centralised suture storage | Inclusion of the OR procurement team as part of the overall OR team within the department |
A condensed list of suture codes |
Description | Value |
---|---|
Stock value pre-intervention October 2018 | €221,052 |
Stock value post-intervention December 2018 | €181,913 |
Percentage reduction %—post-intervention | 17.7% |
Boxes | Codes | Percentage Reduction % | |
---|---|---|---|
Stock Count Pre-Intervention September 2018 | 1112 Boxes | 247 Codes | |
Stock Count Post-Intervention March 2019 | 741 Boxes | 194 codes | 33% |
Stock Count 6 Months Post-Intervention September 2019 | 518 Boxes | 187 codes | 53% |
Description | Value |
---|---|
Stock value pre-intervention December 2017 | €27,000 |
Stock value post-intervention December 2018 | €2231 |
Percentage reduction %—post-intervention | 91.7% |
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O’Mahony, L.; McCarthy, K.; O’Donoghue, J.; Teeling, S.P.; Ward, M.; McNamara, M. Using Lean Six Sigma to Redesign the Supply Chain to the Operating Room Department of a Private Hospital to Reduce Associated Costs and Release Nursing Time to Care. Int. J. Environ. Res. Public Health 2021, 18, 11011. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111011
O’Mahony L, McCarthy K, O’Donoghue J, Teeling SP, Ward M, McNamara M. Using Lean Six Sigma to Redesign the Supply Chain to the Operating Room Department of a Private Hospital to Reduce Associated Costs and Release Nursing Time to Care. International Journal of Environmental Research and Public Health. 2021; 18(21):11011. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111011
Chicago/Turabian StyleO’Mahony, Lisa, Kerrie McCarthy, Josephine O’Donoghue, Seán Paul Teeling, Marie Ward, and Martin McNamara. 2021. "Using Lean Six Sigma to Redesign the Supply Chain to the Operating Room Department of a Private Hospital to Reduce Associated Costs and Release Nursing Time to Care" International Journal of Environmental Research and Public Health 18, no. 21: 11011. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111011