Streamlining the Processes Preceding an Operation Using Six Sigma

Purpose: The operation theatre is the major cost and revenue centre in a hospital. The operation theatre’s optimum utilization will not only increase the revenue for the hospital but will also have a significant positive impact on customer satisfaction, for both internal and external customers. The present study aims in improving the existing process in an operation theatre suite of a tertiary care private hospital in Siliguri (West Bengal), which suffers from a process related problem, delay in scheduling operations (Sigma level 2.17), as found out in the Pilot Study. The study is carried out to improve the sigma level. Aligning with it, the operation theatre utilization is calculated with the objective of its bench marking, as per industry standards.

Design/Methodology/Approach: The study is conducted within the framework of Defining, Measuring, Analysing, Improving, and Controlling (DMAIC) method of Six Sigma. To begin with, the Pilot Study is carried out to identify and define the problem. At the measuring and analysing stage, Pareto analysis technique is employed, aided by the Cause and Effect diagram. After the identification, causes are categorised as controllable and uncontrollable. This is followed by a brainstorming session, which is conducted in order to work out solutions relating to controllable causes. The Time Motion study data of 192 surgery cases is collected for the pre-implementation phase, while that of 236 surgery cases is collected for the post-implementation phase. An independent t test is carried out to find out the difference in the outcomes, both in the pre-implementation and the post-implementation phases, thereby reflecting the effectiveness of the solutions implemented.

Findings: The baseline sigma level of 2.17 is improved to reach the 3.0 sigma level, concerning delay of scheduled operations. This is achieved by reducing the time lag that is experienced when shifting the patient from the Ward to the Operation Theatre, as also that relating to the cleaning and setting up of the Operation Theatre, between two surgeries.

Practical implications: Reducing the set up and the cleaning time between two procedures helps in reducing the delay in scheduled operations, which can be achieved by the practice of shifting the patient one hour prior to the scheduled surgery. Similarly, when more surgeries need to be performed, their turnaround time can be reduced by deploying an adequate number of housekeeping staff. Thus, more number of surgeries can be done in a day and operation theatre utilization can be optimised.