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Related Experiment Video

Updated: Jan 12, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Improving Administrative Processes in a Trauma Centre: Lean and Pareto Approach.

R Harsvardhan1, A Jain1, S Singh1

  • 1Department of Hospital Administration, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India.

Journal of Healthcare Quality Research
|November 2, 2025
PubMed
Summary

Integrating Pareto analysis and Gemba Walks effectively identified and resolved key operational challenges in a trauma centre, improving hospital efficiency through structured quality improvement. This approach enhances service delivery in high-pressure environments.

Keywords:
Análisis de ParetoCentros de traumatologíaControl roomGemba WalkGestión de LeanGestión de calidad totalLean ManagementMejora de la calidadPareto analysisQuality improvementSala de controlTotal Quality ManagementTrauma centres

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Area of Science:

  • Healthcare Management
  • Quality Improvement Science
  • Operations Research

Background:

  • Central Control Rooms (CCR) are vital for hospital operations, coordinating administrative and operational challenges.
  • Trauma centers face high-pressure environments with inefficient workflows impacting service delivery.
  • Lean Management and Total Quality Management principles, including Pareto analysis and Gemba Walk, offer solutions for identifying and solving problems.

Purpose of the Study:

  • To evaluate the effectiveness of integrating Pareto analysis and Gemba Walk in a trauma centre's Central Control Room.
  • To identify and address high-priority operational issues impacting service delivery.
  • To enhance overall hospital efficiency through a structured quality improvement approach.

Main Methods:

  • An interventional study conducted over seven months (April-October 2024) at a trauma centre.
  • Phase I: Pareto analysis of registered complaints in CCR to identify frequent and high-impact issues.
  • Phase II & III: Introduction of Gemba Walk by a multidisciplinary team, followed by post-intervention Pareto analysis to measure impact.

Main Results:

  • Pre-intervention Pareto analysis showed 69.88% of issues originated from 28.6% of complaints.
  • Post-intervention analysis revealed a similar distribution (67.77% of issues from 28.6% of complaints), but with a shift in the nature of problems.
  • Targeted Gemba Walks led to a change in the types of issues encountered, indicating successful problem-solving at the point of occurrence.

Conclusions:

  • The integration of Pareto analysis and Gemba Walk is an effective strategy for identifying and resolving operational challenges in trauma centres.
  • This structured quality improvement approach significantly enhances hospital efficiency and service delivery.
  • Findings underscore the importance of direct observation and multidisciplinary collaboration in addressing complex healthcare operational issues.