Reducing start time delays in operating rooms

Problem: Health care today is facing serious problems: quality of care does not meet patients’ needs and costs are exploding. Inefficient utilization of expensive operating rooms is one of the major problems in many hospitals worldwide. A benchmark study of 13 hospitals in the Netherlands and Belgium showed that, for a variety of reasons, surgery consistently started too late.
Approach: For a short and a somewhat longer period, two selected hospitals from the benchmark study agreed to record the start times of the first operation each day for each of their operating rooms. In addition to start times, the improvement team also recorded potential influence factors (covariates, or X’s). Statistical techniques used during the project were statistical graphics, Pareto charts, histograms, box plots, time-series plots, Box-Cox transformations, and ANOVA to determine possible influential factors.
Results: It is shown that anesthesia technique and specialty are influence factors. However, the poor planning and scheduling process turned out to be the most important factor in the delay of start times. After introducing a new planning process, the hospitals involved were able to gain substantial cost savings, increased efficiency, and substantial reductions of the delay in start times for surgery.
Key Words: ANOVA; Box-Cox transformation; Health Care Quality; Lean Six Sigma; Pareto Charts.