Cutting the fat: Utilizing LEAN methodology to improve rounding efficiency of surgical residents - 20/06/22

Doi : 10.1016/j.amjsurg.2021.12.005

Marcie Feinman ^a,^⁎ , Angela Ting Wei Hsu ^b, Stephanie Taylor ^a, Laura Torbeck ^c
^a Department of Surgery, Sinai Hospital of Baltimore, 2435 Belvedere Ave, Hoffberger Building, Suite 42, Baltimore, MD, 21215, USA
^b Department of Surgery, Johns Hopkins University School of Medicine, 600 North Wolfe St, Blalock 607, Baltimore, MD, USA
^c Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, EH 543, Indianapolis, IN, 46202, USA

^∗Corresponding author. Department of Surgery, Sinai Hospital of Baltimore, 2435 Belvedere Ave, Suite 42, Baltimore, MD, 21215, USA.Department of SurgerySinai Hospital of Baltimore2435 Belvedere AveSuite 42BaltimoreMD21215USA

Abstract

Background

LEAN was developed by Toyota to provide a systematic way to eliminate waste and standardize processes. We sought to introduce LEAN methodology to surgical residents with the goal of increasing rounding efficiency.

Methods

A Kaizen event was used as a rounding efficiency improvement strategy. A multidisciplinary healthcare team participated in the event; first to identify the current state of rounds, second to create the ideal state. Value-stream maps were created and improved efficiency was seen by increased ratio of productive time to lead time.

Results

Two interventions were prioritized. The first introduced table rounds before walk rounds and the second changed the sign-out tool from Baton to Microsoft Word with file encryption. The ratio of productive time to lead time during morning rounds was higher after implementing these interventions (3.73 vs. 2.03).

Conclusions

This Kaizen event introduced surgical trainees to LEAN and resulted in improved efficiency of morning rounds.

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Highlights

•	LEAN can and should be introduced to surgical residents.
•	LEAN can help increase efficiency of a defined workflow.
•	Involvement of all stakeholders is essential.
•	The process of LEAN must be iterative to maximize results.

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Keywords : LEAN, Kaizen event, Surgery, Residency

Plan

Introduction

Methodology

Phase 1: determination of current state

Phase 2: timing of rounds

Phase 3: creation of future state

Phase 4: Implementation of Changes

Export

Vol 223 - N° 6

P. 1100-1104 - juin 2022 Retour au numéro

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Cutting the fat: Utilizing LEAN methodology to improve rounding efficiency of surgical residents - 20/06/22

Abstract

Background

Methods

Results

Conclusions

Highlights

Plan

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