A Business Process Reengineering of the Surgical Path through Lean Technique: The Real Case Study of a Midsize Italian Hospital

This period of pandemic has had important consequences on the flow and the entire organization of any hospital. In particular, the number of accesses to the emergency room has increased, with the consequent urgent need to reorgani ze it quickly. The model proposed in this paper allows to respond to these needs by freeing not only shifts of nursing staff but also surgical staff. This workforce can then be relocated in the emergency room or of the intensive care unit who are in fact at the forefront of emergency management. The aim of this study conducted by the authors is to analyze, inside the context of a midsize Italian hospital, the actual organization model, and then to approach it by Business Process Reengineering (BPR) methodology with the goal to propose a KPI management system that evaluates the efficiency of the whole surgical path. The second objective of the study is to verify if the Operating Rooms (ORs) are properly sized to cover the surgical workload or if it would be necessary to build new ORs (answer to this question is the project mandate by Surgical Wards Chiefs). The last objective is to implement a flexible to cope with emergency situations such as a pandemic. The main result is the approximate maintenance of surgical annual activity (8169 vs 7889). The fewer resources required can be reallocated to deal with emergencies such as the current COVID-19 pandemic. In fact, the surgical shifts decreased during the test case from 464 versus 365 (-15,32%). The rooms’ utilization coefficient rose from 41% to over 52%, whereas the surgeons’ utilization coefficient rose to 61% (with values over 68% for parallel shifts). The results achieved demonstrate that improving efficiency of surgical processes is feasible and a systematic approach allows to respond to new global health challenges.