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Redesigning the Process for Scheduling Elective Orthopaedic Surgery: A Combined Lean Six Sigma and Person-Centred Approach

Author

Listed:
  • Ailish Daly

    (Beacon Hospital Beacon Court, Bracken Rd, Sandyford Business Park, Sandyford, D18 AK68 Dublin, Ireland)

  • Nicola Wolfe

    (Beacon Hospital Beacon Court, Bracken Rd, Sandyford Business Park, Sandyford, D18 AK68 Dublin, Ireland)

  • Seán Paul Teeling

    (UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems UCD Health Sciences Centre, D04 V1W8 Dublin, Ireland
    Centre for Person-Centered Practice Research Division of Nursing, School of Health Sciences, Queen Margaret University Drive, Musselburgh EH21 6UU, East Lothian, UK)

  • Marie Ward

    (Centre for Innovative Human Systems, School of Psychology, Trinity College, The University of Dublin, D02 PN40 Dublin, Ireland)

  • Martin McNamara

    (UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems UCD Health Sciences Centre, D04 V1W8 Dublin, Ireland)

Abstract

The Health Service Executive Ireland model of care for elective surgery supports the delivery of elective surgical care in achieving both process and clinical outcomes. This project was conducted in the Orthopaedic Department. Following an outpatient consultation with an orthopaedic surgeon, patients who required surgical intervention were scheduled for their intervention by the administrative team. Prior to commencing this project, the average time from patient consultation to being scheduled for surgery on the hospital system was 62 h/2.58 days. A pre- and post-team-based intervention design employing Lean Six Sigma methodology was applied to redesign the process for scheduling elective orthopaedic surgery. The project was informed by collaborative, inclusive, and participatory stakeholder engagement. The goal was to streamline the scheduling process for elective orthopaedic surgery, with a target that 90% of surgeries are scheduled “right first time” within 48 h/two working days of the outpatient consultant appointment. The main outcome measures showed that 100% of orthopaedic surgeries were scheduled successfully within 2 days of outpatient appointment. Duplication in work between patient services and scheduling teams was eliminated and facilitated a reduction in unnecessary staff workload. This project highlights the importance of collaborative interdisciplinary stakeholder engagement in the redesigning of processes to achieve sustainable outcomes, and the findings have informed further improvements across the hospital’s surgical scheduling system.

Suggested Citation

  • Ailish Daly & Nicola Wolfe & Seán Paul Teeling & Marie Ward & Martin McNamara, 2021. "Redesigning the Process for Scheduling Elective Orthopaedic Surgery: A Combined Lean Six Sigma and Person-Centred Approach," IJERPH, MDPI, vol. 18(22), pages 1-15, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:22:p:11946-:d:678677
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    References listed on IDEAS

    as
    1. Andrew Castle & Rachel Harvey, 2009. "Lean information management: the use of observational data in health care," International Journal of Productivity and Performance Management, Emerald Group Publishing Limited, vol. 58(3), pages 280-299, March.
    2. Seán Paul Teeling & Jan Dewing & Deborah Baldie, 2021. "A Realist Inquiry to Identify the Contribution of Lean Six Sigma to Person-Centred Care and Cultures," IJERPH, MDPI, vol. 18(19), pages 1-21, October.
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    Cited by:

    1. Diego Tlapa & Ignacio Franco-Alucano & Jorge Limon-Romero & Yolanda Baez-Lopez & Guilherme Tortorella, 2022. "Lean, Six Sigma, and Simulation: Evidence from Healthcare Interventions," Sustainability, MDPI, vol. 14(24), pages 1-25, December.
    2. Ailish Daly & Sean Paul Teeling & Suzanne Garvey & Marie Ward & Martin McNamara, 2022. "Using a Combined Lean and Person-Centred Approach to Support the Resumption of Routine Hospital Activity following the First Wave of COVID-19," IJERPH, MDPI, vol. 19(5), pages 1-20, February.
    3. Sinead Moffatt & Catherine Garry & Hannah McCann & Sean Paul Teeling & Marie Ward & Martin McNamara, 2022. "The Use of Lean Six Sigma Methodology in the Reduction of Patient Length of Stay Following Anterior Cruciate Ligament Reconstruction Surgery," IJERPH, MDPI, vol. 19(3), pages 1-18, January.
    4. Marie E. Ward & Ailish Daly & Martin McNamara & Suzanne Garvey & Sean Paul Teeling, 2022. "A Case Study of a Whole System Approach to Improvement in an Acute Hospital Setting," IJERPH, MDPI, vol. 19(3), pages 1-22, January.
    5. Seán Paul Teeling & Jan Dewing & Deborah Baldie, 2022. "Developing New Methods for Person-Centred Approaches to Adjudicate Context–Mechanism–Outcome Configurations in Realist Evaluation," IJERPH, MDPI, vol. 19(4), pages 1-17, February.
    6. Martin McNamara & Marie Ward & Seán Paul Teeling, 2023. "Making a Sustainable Difference to People, Processes and Systems: Whole-Systems Approaches to Process Improvement in Health Systems," IJERPH, MDPI, vol. 20(7), pages 1-5, March.

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