Streamlining and Consistency in Surgery: Lean Six Sigma to Improve Operating Room Efficiency.

Area of Science:

• Plastic Surgery
• Quality Improvement
• Healthcare Management

Background:

• Perioperative efficiency is crucial for reducing costs, increasing operating room throughput, and enhancing patient safety.
• Lean Six Sigma (LSS), a proven business efficiency model, has limited adoption in medicine.
• This study explores LSS application to optimize plastic surgery operative efficiency.

Purpose of the Study:

• To adapt and implement Lean Six Sigma (LSS) methodologies within plastic surgery.
• To enhance perioperative efficiency for complex reconstructive procedures.
• To reduce surgical expenditure and improve operating room throughput.

Main Methods:

• The study employed the Define, Measure, Analyze, Improve, and Control (DMAIC) phases of LSS.
• Key metrics included total operative time and incision-to-closure time.
• Interventions focused on optimizing surgeon positioning, roles, and preparing specialized surgical trays.

Main Results:

• A total of 181 patients undergoing bilateral deep inferior epigastric perforator flap breast reconstruction were included.
• LSS implementation reduced total operative time from 636.36 to 530.35 minutes.
• Incision-to-closure time decreased from 555.16 to 458.85 minutes.

Conclusions:

• Lean Six Sigma (LSS) effectively improves perioperative efficiency in complex plastic surgery.
• Optimized workflow, surgeon spatial positioning, and distinct roles enhanced intraoperative efficiency.
• The study demonstrates LSS's value in streamlining surgical procedures and improving outcomes.