Increasing Capacity at Art Clinic by Reducing Variation

Abstract

This study investigates the current capacity and limiting factors at the knee and hip replacement surgery process at Art Clinic, with the aim of identifying bottlenecks and proposing improvements to increase surgical throughput. Using a mixed method approach, quantitative data analysis is combined with qualitative observations and interviews. The clinic currently performs eight surgeries per day, with two primary bottlenecks identified: the operating room and the sterile processing room. Operating room inefficiencies stem from high variation in surgical duration, longer setup times for hip replacements and idle time caused by scheduling misalignment. The sterile processing room is limited by the capacity of the autoclaves, limiting the number of knee surgeries to six per day due to the number of instruments. In addition, the postoperative ward was identified as a potential limiting factor depending on daily demand and bed availability To address these issues, the study recommends: (1) Reducing variation through subgroup analysis and improved planning, (2) Optimizing patient readiness to minimize idle time, (3) Enhancing learning and knowledge sharing, (4) Reducing the number of instruments and improving planning in the sterile processing room and (5) Reassessing the bed capacity in the PACU (post anesthesia care unit) due to an imbalance between the PACU and postoperative ward capacity.