Improving Administrative Processes in a Trauma Centre: Lean and Pareto Approach

The Central Control Room (CCR) of hospital plays a pivotal role in the hospital operations by overseeing, coordinating and resolving real-time administrative and operational challenges. Trauma centres operate in high-pressure environment and frequently encounter inefficiently designed workflows that impacts service delivery. Pareto analysis and Gemba Walk, based on Lean Management and Total Quality Management approach, focuses on direct observation by identify high-priority issues and real-time problem solving.

An interventional study was conducted over seven months (April-October 2024) at a trauma centre. In Phase I (April-June), all complaints reported in CCR were registered, categorized and analysed using Pareto analysis to identify the most frequent and high-impact issues. In Phase II (July), Gemba Walk by multidisciplinary team was introduced. During Phase III (August-October 2024), complaints were re-evaluated using Pareto analysis to measure the impact of the intervention.

Introduction of structured complaint tracking using Pareto charts, followed by Gemba Walks involving operations, nursing, engineering, and housekeeping teams to address issues at the point of occurrence.

Pareto analysis done in pre-intervention phase revealed that 69.88% of issues stemmed from 28.6% of the complaints. After targeted Gemba Walk introduction, the post-intervention analysis showed that while 67.77% of issues were still from 28.6% of complaints, however, nature of the problems was different.

Integration of Pareto analysis and Gemba Walk proved to be an effective approach for identifying and resolving key operational challenges in trauma centre. Findings highlight the importance of structured quality improvement approach in enhancing hospital efficiency.