How to increase capacity with existing resources at a surgery unit
Conference contribution, 2019
There are long queues to different kinds of surgery at all public hospitals in Sweden. The bottle-neck to increase the capacity is in most cases the lack of competent personnel. A key for meeting the increasing demand in the future is to use the existing staff in a smarter and more efficient way, i.e. to increase productivity. The physical and psychosocial work environment also need to improve to keep the staff. Surgical operations are among the activities with the most obvious potential for production planning and control. The input and outputs are often clearly defined and the transformation process is to a large extent standardized. This might lead to the belief that the surgical operations process is optimal and that the only way of increasing capacity is to add more resources, however a detailed analysis of all processes and activities reveals that there is a lot that can be improved.
The aim of this research is to demonstrate how the capacity for surgical operations can increase with existing resources by focusing foremost on the set-up time between the actual operations. To practically increase the capacity requires at least one more operation per day.
Material and methods
An activity mapping was used to set up a work sampling study to gather data about the work time distribution on different activities. This was followed by a comprehensive process mapping conducted in a series workshops with different personnel groups. Data about planned operation times were gathered from the production planning system and statistics of real times were collected through a business intelligence interface. Analysis and synthesis were made together with staff and managers.
The result is a number of improvements actions that need to be implemented to achieve the goal of one more operation per day. The single most influential action is to parallelize activities during the changeover phase. One surprising result was that a precondition for implementing any improvement in practice was that some fundamental changes were made to the production planning software.
It is possible to carry out one more operation per day, in this case from 2 to 3 and from 3 to 4, for some of the most frequent surgical procedures. However, several improvement actions are needed: Changeover activities need to be parallelized, variations due to late changes and different disturbances need to decrease and several supporting activities need to be carried out more efficiently.