Lean processes for optimizing OR capacity utilization: prospective analysis before and after implementation of value stream mapping (VSM)

Background The decision to optimize the processes in the operating tract was based on two factors: competition among clinics and a desire to optimize the use of available resources. The aim of the project was to improve operating room (OR) capacity utilization by reduction of change and throughput time per patient. Setting The study was conducted at Centre Hospitalier Emil Mayrisch Clinic for specialized care ( n = 618 beds) Luxembourg (South). Method A prospective analysis was performed before and after the implementation of optimized processes. Value stream analysis and design (value stream mapping, VSM) were used as tools. VSM depicts patient throughput and the corresponding information flows. Furthermore it is used to identify process waste (e.g. time, human resources, materials, etc.). For this purpose, change times per patient (extubation of patient 1 until intubation of patient 2) and throughput times (inward transfer until outward transfer) were measured. VSM, change and throughput times for 48 patient flows (VSM A 1 , actual state = initial situation) served as the starting point. Interdisciplinary development of an optimized VSM (VSM-O) was evaluated. Prospective analysis of 42 patients (VSM-A 2 ) without and 75 patients (VSM-O) with an optimized process in place were conducted. Results The prospective analysis resulted in a mean change time of (mean ± SEM) VSM-A 2 1,507 ± 100 s versus VSM-O 933 ± 66 s ( p