Improving Operating Room Efficiency Using the Six Sigma Methodology

Urology. 2021 Aug:154:141-147. doi: 10.1016/j.urology.2021.02.049. Epub 2021 May 11.


Objective: To help improve operating room efficiency in a tertiary care facility, Six Sigma analysis was utilized. Six Sigma is a technique driven by data, methodology, and a philosophy of continuous improvement to help create a system in which 99.99966% of products are free from defects. This process helps to reduce variability and waste in production, while increasing quality and decreasing cost of the final product.

Methods: The steps of define, measure, analyze, improve, and control (DMAIC) methodology were used. Variables measured included close-to-cut time, patient-out to patient-in time, and room utilization. Statistical analysis was conducted, while an individual was sent to shadow various levels of operating room personnel to help recognize possible shortcomings in the system, including communication and coordination errors.

Results: Baseline results were recorded for each surgical specialty to help determine the specific needs of each OR team. Changes in workflow, such as staggered start anesthesia times, were recommended for each level of personnel based on statistical analysis and observation. Results were followed for several years with initial data showing success of the process. However, ongoing construction and resistance to change has prevented further review.

Conclusion: While Six Sigma can be a valuable tool, it is essential to have a proper leadership team that includes all stake holders. The process requires horizontal and vertical leadership as well as buy-in from all individuals affected by the process. The synergy of these factors is key for success.

MeSH terms

  • Efficiency, Organizational / standards*
  • Humans
  • Operating Rooms / organization & administration*
  • Operating Rooms / standards
  • Patient Care Team / organization & administration
  • Patient Care Team / standards
  • Patient Satisfaction
  • Surgical Procedures, Operative / standards*
  • Total Quality Management / organization & administration*
  • Total Quality Management / standards