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Published on: November 8, 2019
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Implementation and Analysis of a Lean Six Sigma Program in Microsurgery to Improve Operative Throughput in Perforator
Charles Scott Hultman1, Sendia Kim, Clara N Lee
1From the *Division of Plastic Surgery, University of North Carolina Health Care System, Chapel Hill, NC; and †Division of Plastic Surgery, Brigham and Women's Hospital, Harvard University, Boston, MA.
Annals of Plastic Surgery
|May 18, 2016
Summary
Implementing Six Sigma in breast reconstruction significantly reduced operative times and hospital stays, improving financial outcomes without increasing complications. This demonstrates the value of process improvement in microsurgery.
Area of Science:
- Microsurgery
- Plastic Surgery
- Quality Improvement
Background:
- Perforator flaps are a common breast reconstruction method but resource-intensive.
- Optimizing efficiency in microsurgical procedures is crucial.
Purpose of the Study:
- To evaluate the impact of a Six Sigma program on microsurgical breast reconstruction.
- To assess changes in operative time, length of stay, and financial outcomes.
Main Methods:
- Applied Six Sigma methodologies including critical pathway planning and defect reduction.
- Compared pre-Six Sigma, Six Sigma intervention, and post-Six Sigma phases over 5 years.
- Utilized statistical analysis (Student t test, χ analysis) to compare outcomes.
Main Results:
- Total operative time decreased from 714 to 607 minutes (P < 0.01).
- Length of stay reduced from 6.3 to 5.2 days (P = 0.01).
- Physician and hospital revenue per minute increased; complication and reoperation rates remained stable.
Conclusions:
- Six Sigma implementation improved operational and financial efficiency in breast reconstruction.
- Sustained improvements suggest lasting process benefits.
- Potential contribution of a learning curve effect to outcome improvements.
