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Impact of lean six sigma process improvement methodology on cardiac catheterization laboratory efficiency
Abstract
Background Operational inefficiencies are ubiquitous in several healthcare processes. To improve the operational efficiency of our catheterization laboratory (Cath Lab), we implemented a lean six sigma process improvement initiative, starting in June 2010. We aimed to study the impact of lean six sigma implementation on improving the efficiency and the patient throughput in our Cath Lab. Methods All elective and urgent cardiac catheterization procedures including diagnostic coronary angiography, percutaneous coronary interventions, structural interventions and peripheral interventions performed between June 2009 and December 2012 were included in the study. Performance metrics utilized for analysis included turn-time, physician downtime, on-time patient arrival, on-time physician arrival, on-time start and manual sheath-pulls inside the Cath Lab. Results After implementation of lean six sigma in the Cath Lab, we observed a significant improvement in turn-time, physician downtime, on-time patient arrival, on-time physician arrival, on-time start as well as sheath-pulls inside the Cath Lab. The percentage of cases with optimal turn-time increased from 43.6% in 2009 to 56.6% in 2012 (p-trend<0.001). Similarly, the percentage of cases with an aggregate on-time start increased from 41.7% in 2009 to 62.8% in 2012 (p-trend<0.001). In addition, the percentage of manual sheath-pulls performed in the Cath Lab decreased from 60.7% in 2009 to 22.7% in 2012 (p-trend<0.001). Conclusions The current longitudinal study illustrates the impact of successful implementation of a well-known process improvement initiative, lean six sigma, on improving and sustaining efficiency of our Cath Lab operation. After the successful implementation of this continuous quality improvement initiative, there was a significant improvement in the selected performance metrics namely turn-time, physician downtime, on-time patient arrival, on-time physician arrival, on-time start as well as sheath-pulls inside the Cath Lab.
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“review of work processes [38,46,47,48,49]”
From Lean Healthcare Tools for Processes Evaluation: An Integrative Review. (2021) · cites this paper as [46]
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Lean Healthcare Tools for Processes Evaluation: An Integrative Review.
de Barros, L. B., Bassi, L. D. C., Caldas, L. P., Sarantopoulos, A., Zeferino, E. B. B., Minatogawa, V., & Gasparino, R. C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147389 · Cited by 90
Metadata
- Authors
- Agarwal, S., Gallo, J. J., Parashar, A., Agarwal, K. K., Ellis, S. G., Khot, U. N., Spooner, R., Murat Tuzcu, E., & Kapadia, S. R.
- Affiliations
- Cleveland Clinic (US)
- Corresponding author
- Kapadia, Samir R.
- Venue
- Cardiovascular Revascularization Medicine
- Publisher
- Elsevier BV
- Published
- 2016-03
- Volume
- 17
- Issue
- 2
- Pages
- 95-101
- ISSN
- 1553-8389 (ISSN-L)
- OpenAlex
- W2209152511
- Cited by
- 67
- References
- 0
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 6 · 2023: 12 · 2022: 7 · 2021: 8 · 2020: 6 · 2019: 5 · 2018: 8 · 2017: 2 · 2016: 5
- FWCI
- 8.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cardiovascular revascularization medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Decision Sciences › Management Science and Operations Research › Healthcare Operations and Scheduling Optimization
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
- Social Sciences › Business, Management and Accounting › Management Information Systems › Quality and Supply Management
- Keywords
- Lean Six Sigma, catheterization laboratory, process improvement, operational efficiency, patient throughput, turn time, percutaneous coronary intervention, coronary angiography, continuous quality improvement
- MeSH terms
- Catheterization, Peripheral, Delivery of Health Care, Efficiency, Cardiac Catheterization, Humans, Organizational Objectives, Time Factors, Program Evaluation, Coronary Angiography, Process Assessment, Health Care, Models, Organizational, Efficiency, Organizational, Total Quality Management, Quality Indicators, Health Care, Workflow, Endovascular Procedures, Quality Improvement, Time-to-Treatment, Percutaneous Coronary Intervention
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