Case Study on Using Lean Principles to Improve Turnaround Time and First Case Starts in an Operating Room

Hospital operating rooms are experiencing higher costs and less available capacity, yet they typically generate the highest returns of all hospital departments. In the case study described in this paper, a process improvement team in a hospital Operating Room Department at aimed to address these issues by decreasing the turnaround time between surgical cases and increasing the percentage of first cases of the day beginning at their scheduled time. These two performance metrics were targeted for improvement through the use of lean work system principles implemented by a cross-functional process improvement team of OR employees aided by external consultants. This systematic improvement project resulted in significant improvement in on-time first case starts and slight overall improvement in turnaround time by the time the formal process improvement project concluded. This paper summarizes the overall approach used by the team, key tools applied and associated findings, results for performance metrics, and potential future improvements.