Lean-healthcare approach to reduce costs in a sterilization plant based on surgical tray rationalization

Abstract

Sterilization plants process all reusable materials used in hospitals during different stages of healthcare provision. Most items sterilized come from the surgical theater in the form of individual instruments, linen and surgical trays. Reducing the number of instruments in trays impacts on the performance of the sterilization process. Here, we propose a three-phase method, based on lean healthcare principles, cluster analysis and kaizen groups of experts to rationalize surgical trays, reducing sterilization processing costs. We innovate by proposing a strategy to approach tray rationalization prioritizing surgical specialties that are both complex and frequent, and by using group technology to cluster surgical trays expediting expert analyses carried out by kaizen groups. Our propositions were tested in a high complexity, tertiary care hospital, covering 12 surgical specialties, reducing the number of instruments by average 9.75%, and the time-to-assemble trays by average 9.68%, obtaining annual savings of US$285.756,00 in sterilization processing costs.

Keywords:

• Lean healthcare
• kaizen groups
• sterilization plant
• rationalization
• operating room logistics
• surgical trays

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Coordena¸ão de Aperfei¸oamento de Pessoal de Nível Superior [42001013059P3].

Notes on contributors

Flavio S. Fogliatto

Prof. Flavio S. Fogliatto holds a Ph.D. in Industrial and Systems Engineering from Rutgers University, USA (1997). He was visiting scholar at the CNAM (Paris, France) in 2005–2006. Currently, he is a Full Professor at the IE Department of the Federal University of Rio Grande do Sul (Brazil), and Graduate Director of the IE Graduate Program in that same institution. His research interests are healthcare operations management, quality control and optimization of products and processes, mass customization, and quantitative methods in production control. His research is funded by CNPq [Grant # 303509/2015-5].

Michel J. Anzanello

Michel J. Anzanello is an Associate Professor at the Industrial Engineering Department of the Federal University of Rio Grande do Sul (UFRGS), Brazil. He received a BSc in Chemical Engineering (2001) and an MSc in Industrial Engineering (2004) from UFRGS, and a PhD in Industrial Engineering (2009) from RUTGERS-The State University of New Jersey (USA). His main research areas include data mining, multivariate analysis, simulation, learning curve modelling and production planning and control. His research has been published in journals such as Chemometrics and Intelligent Laboratory Systems, International Journal of Production Economics and Pharmaceutical and Biomedical Analysis.

Leandro M. Tonetto

Leandro Miletto Tonetto is a Professor of Design at Universidade do Vale do Rio dos Sinos (Brazil) and co-founder of Zooma Consumer Experience. His research focuses on design for well-being as a means to foster human development and health. He is a board member of the Special Interest Group in Wellbeing, Happiness, and Health (SIGWell) of the Design Research Society. His research is funded by CNPq [Grant # 307113/2017-5].

Daniela S. S. Schneider

Daniela S. S. Schneider holds a Master’s Degree in Genetics and Toxicology (Brazilian Lutheran University, 2010) and is currently Ph.D. student at the Nursing Graduate Program of Universidade Federal do Rio Grande do Sul, Brazil. She works as chief nurse at the Sterilization facility of Hospital de Clinicas de Porto Alegre, Brazil.

Ana Maria Muller Magalhães

Ana Maria Müller de Magalhães is an Associate Professor at School of Nursing and Permanent Professor at the Nursing Graduate Program of Universidade Federal do Rio Grande do Sul, Brazil. She earned a Ph.D. degree in Nursing from UFRGS. Her research interest includes planning and organization of nursing services, healthcare quality assessment, patient safety, nursing workload, lean healthcare and patient safety. Her current research aims to analyze how characteristics of the nursing professional practice environment and the complexity of the care systems impact the quality of care and safety of hospitalized patients.