International Journal of Mathematical, Engineering and Management Sciences

ISSN: 2455-7749

Quality Assurance for Operating Room Illumination through Lean Six Sigma

Yucel Ozturkoglu
Department of Logistics Management, Yasar University, Universite Caddesi, No: 37-39, Bornova, Izmir, Turkey.

Yigit Kazancoglu
Department of Logistics Management, Yasar University, Universite Caddesi, No: 37-39, Bornova, Izmir, Turkey.

Muhittin Sagnak
Department of Information Management, Izmir Kâtip Celebi University, Balatcik Kampusu, 35620, Cigli, Izmir, Turkey.

Jose Arturo Garza-Reyes
Center for Supply Chain Improvement, The University of Derby, Kedleston Road Campus, Derby, DE22 1GB, UK.

DOI https://doi.org/10.33889/IJMEMS.2021.6.3.045

Received on December 09, 2020
  ;
Accepted on February 14, 2021

Abstract

Since every mistake made in the healthcare industry can cause permanent harm or even death, some fundamental requirements should be considered when planning and designing operating rooms. Lighting is one of the most important ergonomic factors, especially for operating rooms. This paper investigates the integration of the lean approach and six sigma in measuring the efficiency of LED technology, which can also be regarded as a factor affecting the operating room efficiency. Measurement System Analysis (MSA) and Gage Control methods were applied to determine measurement variability in operating room illumination measurement process. Repeatability and reproducibility (%R&R) was found 12.89%. After calibration, %R&R value was found 8.21%, which implies that calibration helped reduce variability.

Keywords- Operating rooms, Lighting, Lean approach, Six sigma, Measurement system analysis, Gage control.

Citation

Ozturkoglu, Y., Kazancoglu, Y., Sagnak, M., & Garza-Reyes, J. A. (2021). Quality Assurance for Operating Room Illumination through Lean Six Sigma. International Journal of Mathematical, Engineering and Management Sciences, 6(3), 752-770. https://doi.org/10.33889/IJMEMS.2021.6.3.045.

Conflict of Interest

The authors confirm that is no conflict of interest to declare for this publication.

Acknowledgements

Authors express their sincere thanks to the private hospital fort the case study.

References

Aganovic, A., Cao, G., Stenstad, L.I., & Skogås, J.G. (2017). Impact of surgical lights on the velocity distribution and airborne contamination level in an operating room with laminar airflow system. Building and Environment, 126, 42-53.

Ahmed, S., Abd Manaf, N.H., & Islam, R. (2019). Effects of Six Sigma initiatives in Malaysian private hospitals. International Journal of Lean Six Sigma, 10(1), 44-57.

Albayrak, A., Kazemier, G., Meijer, D.W., & Bonjer, H.J. (2004). Current state of ergonomics of operating rooms of Dutch hospitals in the endoscopic era. Minimally Invasive Therapy & Allied Technologies, 13(3), 156-160.

Antony, J., & Kumar, M. (2012). Lean and Six Sigma methodologies in NHS Scotland: an empirical study and directions for future research. Quality Innovation Prosperity, 16(2), 19-34.

Antony, J., Forthun, S.C., Trakulsunti, Y., Farrington, T., McFarlane, J., Brennan, A., & Dempsey, M. (2019). An exploratory study into the use of lean six sigma to reduce medication errors in the Norwegian public healthcare context. Leadership in Health Services, 32(4), 509-524.

Arthur, J. (2011). Lean Six Sigma for hospitals: Simple steps to fast, affordable, and flawless healthcare. Tata McGraw-Hill Education, New York.

Attaallah, A.F., Elzamzamy, O.M., Phelps, A.L., Ranganthan, P., & Vallejo, M.C. (2016). Increasing operating room efficiency through electronic medical record analysis. Journal of Perioperative Practice, 26(5), 106-113.

Azouz, S., Boyll, P., Swanson, M., Castel, N., Maffi, T., & Rebecca, A.M. (2019). Managing barriers to recycling in the operating room. The American Journal of Surgery, 217(4), 634-638.

Besterfield, D.H. (2004). Quality Control. Pearson.

Bhat, S., & Jnanesh, N.A. (2013). Enhancing performance of the health information department of a hospital using lean Six Sigma methodology. International Journal of Six Sigma and Competitive Advantage, 8(1), 34-50.

Bhat, S., Gijo, E.V., & Jnanesh, N.A. (2014). Application of lean six sigma methodology in the registration process of a hospital. International Journal of Productivity and Performance Management, 63(5), 613-643.

Blouin-Delisle, C.H., Drolet, R., Gagnon, S., Turcotte, S., Boutet, S., Coulombe, M., & Daneau, E. (2018). Improving flow in the OR: how lean process studies can lead to shorter stays in the recovery ward. International Journal of Health Care Quality Assurance, 31(2), 150-161.

Brackett, T., Comer, L., & Whichello, R. (2013). Do lean practices lead to more time at the bedside? Journal for Healthcare Quality, 35(2), 7-14.

Budhiraja G.D. (2010). The Natural Way of Healthy Aging. Diamond Pocket Books Ltd.

Burgess, N., & Radnor, Z. (2013). Evaluating lean in healthcare. International Journal of Health Care Quality Assurance, 26(3), 220-235.

Cardoen, B., Demeulemeester, E., & Beliën, J. (2010). Operating room planning and scheduling: a literature review. European Journal of Operational Research, 201(3), 921-932.

Cima, R.R., Brown, M.J., Hebl, J.R., Moore, R., Rogers, J.C., Kollengode, A., Amstutz, G.J., Weisbrod, C.A., Narr, B.J., Deschamps, C., & Team, S.P.I. (2011). Use of lean and six sigma methodology to improve operating room efficiency in a high-volume tertiary-care academic medical center. Journal of the American College of Surgeons, 213(1), 83-92.

Cookson, D., Read, C., Mukherjee, P., & Cooke, M. (2011). Improving the quality of emergency department care by removing waste using lean value stream mapping. The International Journal of Clinical Leadership, 17(1), 25-30.

D’Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: a comprehensive review. Health Policy, 119(9), 1197-1209.

Dalalah, D., & Diabat, A. (2015). Repeatability and reproducibility in med labs: a procedure to measurement system analysis. IET Science, Measurement & Technology, 9(7), 826-835.

De Souza, L.B. (2009). Trends and approaches in lean healthcare. Leadership in Health Services, 22(2), 121-139.

Deblois, S., & Lepanto, L. (2016). Lean and Six Sigma in acute care: a systematic review of reviews. International Journal of Health Care Quality Assurance, 29(2), 192-208.

DelliFraine, J.L., Langabeer, J.R., & Nembhard, I.M. (2010). Assessing the evidence of six sigma and lean in the health care industry. Quality Management in Healthcare, 19(3), 211-225.

Drury, N.E., Pollard, R., & Dyer, J.P. (2004). Minimally invasive surgery: only as good as the picture. Annals of the Royal College of Surgeons of England, 86(1), 40-41.

Fairley, M., Scheinker, D., & Brandeau, M.L. (2019). Improving the efficiency of the operating room environment with an optimization and machine learning model. Health Care Management Science, 22(4), 756-767.

Fong, A.J., Smith, M., & Langerman, A. (2016). Efficiency improvement in the operating room. Journal of Surgical Research, 204(2), 371-383.

Gijo, E.V., & Antony, J. (2014). Reducing patient waiting time in outpatient department using lean six sigma methodology. Quality and Reliability Engineering International, 30(8), 1481-1491.

Glasgow, J.M., Scott-Caziewell, J.R., & Kaboli, P.J. (2010). Guiding inpatient quality improvement: a systematic review of lean and six sigma. The Joint Commission Journal on Quality and Patient Safety, 36(12), 533-540.

Green, L.V., Savin, S., & Murray, M. (2007). Providing timely access to care: what is the right patient panel size? The Joint Commission Journal on Quality and Patient Safety, 33(4), 211-218.

Griefahn, B. (1992), Arbeitsmedizin. In: Schlick, C., Luczak, H., & Bruder, R. (eds) Arbeitsperson. Enke, Stuttgart.

Hajipour, V., Kazemi, A., & Mousavi, S.M. (2013). A fuzzy expert system to increase accuracy and precision in measurement system analysis. Measurement, 46(8), 2770-2780.

Hallam, C.R., & Contreras, C. (2018). Lean healthcare: scale, scope and sustainability. International Journal of Health Care Quality Assurance, 31(7), 684-696.

Harders, M., Malangoni, M.A., Weight, S., & Sidhu, T. (2006). Improving operating room efficiency through process redesign. Surgery, 140(4), 509-516.

Hassanain, M. (2017). An overview of the performance improvement initiatives by the ministry of health in the kingdom of Saudi Arabia. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 1-6.

Heinbuch, S.E. (1995). A case of successful technology transfers to health care: total quality materials management and just-in-time. Journal of Management in Medicine, 9(2), 48-56.

Ibrahim, A.M., Dimick, J.B., & Joseph, A. (2017). Building a better operating room: views from surgery and architecture. Annals of Surgery, 265(1), 34-36.

Ide, T., Kinugawa, Y., Nobae, Y., Suzuki, T., Tanaka, Y., Toda, I., & Tsubota, K. (2015). LED light characteristics for surgical shadow less lamps and surgical loupes. Plastic and Reconstructive Surgery Global Open, 3(11), Article number e562.

Jones, D., & Filochowski, J. (2006). Lean healthcare: think yourself thin. The Health Service Journal, 116(6000), 6-7.

Joosten, T., Bongers, I., & Janssen, R. (2009). The application of lean to healthcare: issues and observations. International Journal for Quality in Health Care, 21(5), 341-347.

Kaltenbrunner, M., Mathiassen, S.E., Bengtsson, L., & Engström, M. (2019). Lean maturity and quality in primary care. Journal of Health Organization and Management, 33(2), 141-154.

Kamsah, N., Kamar, H.M., Alhamid, M.I., & Yinn, W.K. (2018). Impacts of temperature on airborne particles in a hospital operating room. Journal of Advanced Research in Fluid Mechanics and Thermal Sciences, 44(1), 12-23.

Katz, J.D. (2017). Control of the environment in the operating room. Anesthesia & Analgesia, 125(4), 1214-1218.

Kaya, O.I., Moran, M., Ozkardes, A.B., Taskin, E.Y., Seker, G.E., & Ozmen, M.M. (2008). Ergonomic problems encountered by the surgical team during video endoscopic surgery. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 18(1), 40-44.

Kim, C.S., Spahlinger, D.A., Kin, J.M., & Billi, J.E. (2006). Lean health care: what can hospitals learn from a world‐class automaker? Journal of Hospital Medicine: an official publication of the Society of Hospital Medicine, 1(3), 191-199.

Krupka, D.C., & Sandberg, W.S. (2006). Operating room design and its impact on operating room economics. Current Opinion in Anaesthesiology, 19(2), 185-191.

Kuo, C.C, & Huang, P.J. (2013) Repeatability and reproducibility study of thin film optical measurement system. Optik-International Journal for Light and Electron Optics, 124(18), 3489-3493.

Laureani, A., Brady, M., & Antony, J. (2013). Applications of lean six sigma in an Irish hospital. Leadership in Health Services, 26(4), 322-337.

Macario, A., Vitez, T.S., Dunn, B., & McDonald, T. (1995). Where are the costs in perioperative care? analysis of hospital costs and charges for inpatient surgical care. The Journal of the American Society of Anesthesiologists, 83(6), 1138-1144.

Madni, T.D., Imran, J.B., Clark, A.T., Arnoldo, B.A., Phelan, H.A., & Wolf, S.E. (2017). Analysis of operating room efficiency in a burn center. Journal of Burn Care & Research, 39(1), 89-93.

Matern, U., & Koneczny, S. (2007). Safety, hazards and ergonomics in the operating room. Surgical Endoscopy, 21(11), 1965-1969.

McIntosh, B., Sheppy, B., & Cohen, I. (2014). Illusion or delusion-lean management in the health sector. International Journal of Health Care Quality Assurance, 27(6), 482-492.

Montella, E., Di Cicco, M.V., Ferraro, A., Centobelli, P., Raiola, E., Triassi, M., & Improta, G. (2017). The application of lean six sigma methodology to reduce the risk of healthcare-associated infections in surgery departments. Journal of Evaluation in Clinical Practice, 23(3), 530-539.

Montgomery, D.C. (2007). Introduction to statistical quality control. John Wiley & Sons, New York.

Pan, C.T., Chen, Y.C., Yang, T.L., Lin, P.H., Lin, P.H., & Huang, J.C. (2016). Study of reflection-typed LED surgical shadow less lamp with thin film Ag-based metallic glass. Optik, 127(4), 2193-2196.

Pyzdek, T., & Keller, P.A. (2003). Quality Engineering Handbook. CRC Press.

Quillin, R.C., Cortez, A.R., Garcia, M.A., Winer, L.K., Kassam, A.F., Kuethe, J.W., & Pritts, T.A. (2019). Gas off, room lights on: shedding light on the surgical resident’s experience in open and laparoscopic surgery. Surgery, 166(4), 460-468.

Radnor, Z., & Boaden, R. (2008). Lean in the public services: panacea or paradox? Public Money and Management, 28(1), 3-7.

Refaie, R., Rushton, P., McGovern, P., Thompson, D., Serrano-Pedraza, I., Rankin, K.S., & Reed, M. (2017). The effect of operating lights on laminar flow: an experimental study using neutrally buoyant helium bubbles. The Bone & Joint Journal, 99(8), 1061-1066.

Sagnak, M., & Kazancoglu, Y. (2016). Integration of green lean approach with six sigma: an application for flue gas emissions. Journal of Cleaner Production, 127, 112-118.

Seagull, F.J. (2012). Disparities between industrial and surgical ergonomics. Work, 41(1), 4669-4672.

Shah, R., & Ward, P.T. (2003). Lean manufacturing: context, practice bundles, and performance. Journal of Operations Management, 21(2), 129-149.

Smith, C.D., Spackman, T., Brommer, K., Stewart, M.W., Vizzini, M., Frye, J., & Rupp, W.C. (2013). Re-engineering the operating room using variability methodology to improve health care value. Journal of the American College of Surgeons, 216(4), 559-568.

Sonmez, A., Unlu, B., Ozgen, C., Bestel, E., Celik, H.H, Kara, H.H., Kunduraci, I.F., Yaran, O., Akkustur, Z., & Isler, Y. (2016). Led teknolojilerinin ameliyathane lambalarında kullanımı. retrieved from: http://www.emo.org.tr/ekler/34ef4d1f815fba3_ek.pdf

Souza, T.A., Vaccaro, G.L.R., & Lima, R.M. (2020). Operating room effectiveness: a lean health-care performance indicator. International Journal of Lean Six Sigma, 11(5), 987-1002.

Stahl, J.E., Sandberg, W.S., Daily, B., Wiklund, R., Egan, M.T., Goldman, J.M., Isaacson, K.B., Gazelle, S., & Rattner, D.W. (2006). Reorganizing patient care and workflow in the operating room: a cost-effectiveness study. Surgery, 139(6), 717-728.

Teich, S.T., & Faddoul, F.F. (2013). Lean management-the journey from toyota to healthcare. Rambam Maimonides Medical Journal, 4(2), 1-9.

Trakulsunti, Y., & Antony, J. (2018). Can lean six sigma be used to reduce medication errors in the health-care sector? Leadership in Health Services, 31(4), 426-433.

Van den Heuvel, J., Does, R.J., & De Koning, H. (2006). Lean six sigma in a hospital. International Journal of Six Sigma and Competitive Advantage, 2(4), 377-388.

Walley, P. (2003). Designing the accident and emergency system: lessons from manufacturing. Emergency Medicine Journal, 20(2), 126-130.

Waring, J.J., & Bishop, S. (2010). Lean healthcare: rhetoric, ritual and resistance. Social Science & Medicine, 71(7), 1332-1340.

Wolfe, A. (2001). Institute of medicine report: crossing the quality chasm: a new health care system for the 21st century. Policy, Politics, & Nursing Practice, 2(3), 233-235.

Zheng, C., Dai, M., Zhang, Z., & Hu, Y. (2016). Intelligent control system of medical shadow-less lamps based on STM32. In 2006: 23rd International Conference on Mechatronics and Machine Vision in Practice (M2VIP) (pp.1-4). IEEE. Nanjing, China.

Zidel, T. (2006). A lean guide to transforming healthcare: how to implement lean principles in hospitals. medical offices, clinics, and other healthcare organizations, [online] Google Books. Quality Press.

Privacy Policy| Terms & Conditions