Increasing available operative time of the operating room - A case study at a Swedish University Hospital

Examensarbete för masterexamen
Master Thesis
Supply chain management (MPSCM), MSc
Ramita, Na Nakorn
Nasrabadi, Mitra
The increasing trend on performing the prosthetic surgeries in Sweden has been indicated by researches. This is due to the fact that the quality of health care has been improved and new techniques have been developed to create comfort for the people. Notwithstanding the high quality of health care services in Sweden, there is space for efficiency improvement as budget and resources are limited and cannot respond to the demand. Operating rooms are considered to be the most expensive. However, the constraint in resources, increased waiting times and delays, late cancellation, lack of information sharing lead to inefficient use of these valuable resources as remarkable portion of operating room time is taken by non-operative activities. Implementing lean in the healthcare organizations, can help improve the quality of care by identifying the wastes and eliminating them from the procedures and create more efficient operations and reduce the time between operations. This study has focused on identification of wastes that reduce the available operative time of operating room at the prosthetic section of an operation department at a university hospital in Sweden. Accordingly, the purpose of the thesis is defined as contributing to available operative time. The study has been performed to provide the operation department of the case study with clearer picture of where, how and why the wastes happen in the department, what are their impact, and provide some suggestions based on literature, so that the wastes can be mitigated and increasing available operative time become feasible. The authors have observed the processes at the operation department for about four months and conducted several interviews with the staff of the department to gain understanding of the procedures and identify the wastes. Seven wastes of lean management have been used as a tool to discern what can be the waste activities in the operation department. After the waste identification step, the cause of each waste has been analysed by means of fishbone diagram and it has been explained that the causes trace back to people, environment, method and equipment. Although, the causes were identified during observations and interviews with personnel, using fishbone diagram and previous studies helped at categorizing and build consensus with previous studies. In the next step, impacts of identified wastes on available operative time were assessed through quantitative analysis and qualitative valuation. Efficiency measures such as non-operative time and changeover time were assessed to understand how the waste times and activities can lead to reduction of available operative time. After assessing impact of wastes on available operative time, some particular wastes have been identified as the wastes with highest effect on available operative time, which are inducing anaesthesia inside the operating room, preparing instruments for total revision surgeries inside the OR, long changeover time and long patient preparation time in the OR. Correspondingly, the main causes are also identified as insufficient number of room for anaesthesia induction outside the OR, lack of space in instrument preparation room, lack of proper communication and information sharing among staff and absence of standardisation that prolong the duration of some activities. Finally, the identified wastes and their impact on reduction of available operative time have been compared to previous studies and literature, limitation of the study has been pointed out and the conclusion has been made.
Transport , Övrig industriell teknik och ekonomi , Transport , Other industrial engineering and economics
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