A systematic review of intraoperative process mapping in surgery

Area of Science:

• Surgical Process Improvement
• Quality Management in Healthcare
• Medical Education Technology

Background:

• Process mapping is a recognized strategy for enhancing surgical efficiency, yet its application in literature and practice remains inconsistent.
• Previous work demonstrated process mapping's benefits in complex procedures like autologous breast reconstruction, improving efficiency, teaching, education, and audit.
• The intraoperative period presents a significant opportunity for applying process mapping beyond breast reconstruction to various surgical procedures.

Purpose of the Study:

• To systematically review the current utilization of process mapping within the intraoperative surgical period.
• To identify common areas of improvement and outcome measures associated with process mapping interventions.
• To synthesize findings regarding the application and reporting of process mapping in surgical contexts.

Main Methods:

• A systematic review was conducted across Ovid MEDLINE, Allied and Complementary Medicine Database, Embase, and PsychINFO.
• Manual reference searching of identified articles was performed to ensure comprehensive data capture.
• Data extraction focused on methods, applications, and outcomes related to process mapping in the intraoperative period, followed by descriptive analysis.

Main Results:

• Seventeen studies (out of 1,488) met the eligibility criteria, all being non-randomized.
• Process mapping was applied to various components of the intraoperative period, with common areas for improvement identified.
• Ten studies assessed outcomes after implementing interventions based on process mapping, aiming to increase surgical efficiency.

Conclusions:

• Process mapping, despite inconsistent nomenclature, is utilized within broader quality improvement initiatives to enhance surgical efficiency.
• While applied across surgical specialties, its specific application to the surgical component of the intraoperative period is lacking.
• Standardized reporting and description of process mapping are crucial for advancing research and evidencing its benefits in surgery.