Using lean methods to improve OR turnover times.

were experiencing difficulty meeting OR turnover goals. Extended turnovers increased patient and physician wait times and disrupted flow in the OR suite. The team averaged 20 minutes to complete room turnovers, and in some observed cases, they required 25 minutes. Absent personnel, missing supplies , delayed delivery of the patient to the OR, and undefined responsibilities were just a few of the factors affecting the team's turnover efficiency. Additionally , analysis of historical performance revealed a large degree of variation in room turnovers, indicating a lack of consistency within the process (Figure 1). The challenge for the OR staff was to reduce wait times by improving room turnovers while increasing process consistency to positively affect patient safety. Given the state of turnover time performance , the team at Parkridge Medical Center turned to lean health care methodologies for a solution. Lean Healthcare is a term that is permeating the consciousness of an industry that has for a long time struggled with skyrocketing costs, poor customer and employee satisfaction, complex and cumbersome [information tech-nology] solutions, nursing shortages, physician frustration, and life and death problems caused by inadvertent errors and oversights. 1 Lean concepts, originally developed in the automotive industry, have since been deployed across multiple manufacturing and service industries to deliver high-quality products and services while improving organizational performance and satisfying customers. Recently, some organizations have begun adapting these concepts for the health care industry. The goal of lean health care is to approach processes with a keen eye for waste, as well as reducing wait times and unnecessary travel, while building quality, speed, and flexibility into the organization. Today, patients have more freedom to choose where they receive their medical services , so lean health care actually can be part of a growth strategy. By fo-cusing on removing waste in daily activities, a facility increases the time staff members have to directly care for patients. Patient outcomes and the overall patient experience is enhanced, and this creates a growth opportunity for the health care organization. Personnel from Parkridge Medical Center, with the assistance of an experienced lean health care facilitator, formed a Kaizen (ie, rapid improvement) team to focus on the turnover time issue. This team was composed of one RN, two radiology technologists, two scrub persons, and the director of surgical services. To improve room turnover performance, the team employed the lean tools of standard work and the assembly …