Quality improvement through lean A3 method for foot traffic in operating room

Abstract

Background: traffic in the operating rooms (ORs) is known to be a factor affecting surgical site infections (SSIs) and distractions. Therefore, it is essential to reduce the number of door openings during operations. Accordingly, the main purpose of this study was to investigate the impact of the A3 method, as a lean management tool, on foot traffic in ORs. Methods: This quality improvement study was conducted in three phases, lasting three months, at a main teaching hospital. In this respect, a digital counter and a time attendance machine were mounted on the hospital OR doors. Then, the seven steps of the A3 process as the intervention were fulfilled and three focus group sessions were held. Besides, a researcher-made checklist was utilized to record the specifics of each operation and its related events. Results: Finally, a total of 97 surgeries performed in ORs were included to reflect on the problem of door openings during operations. Using the A3 method as an intervention resulted in a 46 reduction in foot traffic in ORs. On average, door openings per case decreased from 54.90 to 31.97 times in this study. Conclusions: The A3 method was effective in mitigating the volume of traffic in ORs and moderated it by almost half. Among other effects of this process was that it encouraged collaboration between the health care team members. © 2021