How can lean thinking improve ERAS program in bariatric surgery?

Area of Science:

• Bariatric Surgery
• Surgical Outcomes
• Healthcare Management

Background:

• Enhanced Recovery After Bariatric Surgery (ERABS) protocols aim to optimize patient recovery.
• Operating room (OR) logistics can significantly impact surgical efficiency and patient outcomes.
• Lean management principles offer a framework for improving healthcare operational efficiency.

Purpose of the Study:

• To evaluate the clinical and operational impact of an ERABS protocol in bariatric surgery.
• To assess the effect of ERABS on length of hospital stay (LOS) and clinical outcomes.
• To analyze the influence of ERABS, utilizing lean management, on operating room (OR) efficiency and time savings.

Main Methods:

• Retrospective analysis of 232 patients in the ERABS group versus 239 patients in the standard care (control) group undergoing bariatric surgery.
• Comparison of preoperative, intraoperative, and postoperative data, including LOS, complications, readmissions, and reoperations.
• Evaluation of OR logistic endpoints: surgical time, team work time, and total anesthesia time.

Main Results:

• ERABS group showed a significantly shorter mean LOS (3.16 days) compared to the control group (4.81 days).
• No significant differences in clinical outcomes (complications, readmissions) were observed between the groups.
• ERABS significantly reduced surgical procedure time, total anesthesia time, and team work time (p < 0.001).

Conclusions:

• The ERABS protocol is a safe and feasible alternative that improves LOS in bariatric surgery patients.
• Implementing lean management for OR reorganization enhances efficiency, reduces OR times, and contributes to improved LOS.
• ERABS demonstrates potential for optimizing bariatric surgery care through improved logistics and patient recovery.