Access to surgical care as an efficiency issue: using lean management in French and Australian operating theatres

Zeyad Mahmoud (zeyad.mahmoud@outlook.com), Nathalie Angelé-Halgand (nathalie.angele-halgand@unc.nc), Kate Churruca, Louise Ellis and Jeffrey Braithwaite
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Zeyad Mahmoud: Macquarie University [Sydney], LEMNA - Laboratoire d'économie et de management de Nantes Atlantique - IEMN-IAE Nantes - Institut d'Économie et de Management de Nantes - Institut d'Administration des Entreprises - Nantes - UN - Université de Nantes
Nathalie Angelé-Halgand: LEMNA - Laboratoire d'économie et de management de Nantes Atlantique - IEMN-IAE Nantes - Institut d'Économie et de Management de Nantes - Institut d'Administration des Entreprises - Nantes - UN - Université de Nantes, UNC - Université de la Nouvelle-Calédonie
Kate Churruca: Macquarie University [Sydney]
Louise Ellis: Macquarie University [Sydney]
Jeffrey Braithwaite: Macquarie University [Sydney]

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Abstract: Purpose Millions around the world still cannot access safe, timely and affordable surgery. Considering access as a function of efficiency, this paper examines how the latter can be improved within the context of operating theatres. Carried out in France and Australia, this study reveals different types of waste in operating theatres and a series of successful tactics used to increase efficiency and eliminate wastefulness. Design/methodology/approach Data for this qualitative study were collected through 48 semi-structured interviews with operating theatre staff in France ( n = 20) and Australia ( n = 28). Transcripts were coded using a theory-driven thematic analysis to characterise sources of waste in operating theatres and the tactics used to address them. Findings The study confirmed the prominence of seven types of waste in operating theatres commonly found in industry and originally identified by Ohno, the initiator of lean: (1) underutilised operating rooms; (2) premature or delayed arrival of patients, staff or equipment; (3) need for large onsite storage areas and inventory costs; (4) unnecessary transportation of equipment; (5) needless staff movements; (6) over-processing and (7) quality defects. The tactics used to address each of these types of waste included multiskilling staff, levelling production and implementing just-in-time principles. Originality/value The tactics identified in this study have the potential of addressing the chronic and structurally embedded problem of waste plaguing health systems' operating theatres, and thus potentially improve access to surgical care. In a global context of resource scarcity, it is increasingly necessary for hospitals to optimise the ways in which surgery is delivered.

Keywords: Lean; Waste; Surgery; Efficiency; Operating theatres management (search for similar items in EconPapers)
Date: 2021-05-27
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Published in Journal of Health Organization and Management, 2021, 35 (5), pp.628-642. ⟨10.1108/jhom-08-2020-0347⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04486123

DOI: 10.1108/jhom-08-2020-0347

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