Optimising theatre utilisation remains a critical challenge for surgical units worldwide, especially during the post-pandemic recovery phase. Lean Six Sigma provides a structured, data-driven methodology to address these operational gaps. By applying the DMAIC framework (Define, Measure, Analyse, Improve, Control), healthcare administrators can identify specific bottlenecks within the surgical pathway. Consequently, hospitals can achieve significant improvements in throughput without compromising clinical safety.

Applying Lean Six Sigma for Optimising Theatre Utilisation

A recent quality improvement study at the Western Eye Hospital demonstrated the efficacy of this approach. Although the baseline utilisation sat at 75.8%, the team aimed to reach the national target of 85%. During the Analyse phase, they discovered that under-performance primarily stemmed from limited pre-assessment capacity rather than late starts. Furthermore, factors such as early finishes and scheduling errors were significant drivers of inefficiency. Specifically, these findings challenged long-held assumptions about why operating rooms often stand empty.

To address these issues, the clinical team implemented several targeted interventions. They increased pre-assessment capacity to ensure a steady flow of ready patients. Additionally, they introduced structured daily reviews of equipment and implant availability to prevent avoidable cancellations. Statistical Process Control helped the team monitor performance and maintain stability throughout the project. As a result, capped theatre utilisation improved to 81%, proving that systematic changes lead to sustainable operational gains.

The Role of DMAIC in Hospital Management

The DMAIC model offers a scalable solution for various medical departments. In the Improve phase, clinicians use Plan-Do-Study-Act cycles to test changes in real-time. This process ensures that every intervention is evidence-based and effective. Moreover, the Control phase ensures that improvements remain permanent through continuous monitoring. By focusing on root causes like under-booking, surgical units can maximise their resources effectively. In conclusion, combining advanced statistical analysis with Lean methodologies offers a robust pathway for enhancing hospital efficiency.

Frequently Asked Questions

What are the primary benefits of using Lean Six Sigma in surgical theatres?

Lean Six Sigma helps healthcare teams identify non-value-added activities and reduce process variation. This leads to higher theatre throughput, fewer on-the-day cancellations, and improved financial sustainability for the healthcare institution.

How does pre-assessment capacity impact theatre utilisation?

Limited pre-assessment capacity often leads to under-booking and last-minute cancellations. By increasing this capacity, hospitals ensure that enough patients are medically fit for surgery, which allows for a more efficient and fully booked theatre schedule.

Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Hemaida I et al. Optimising theatre utilisation through Lean Six Sigma: A model for sustainable theatre utilisation improvement. J Perioper Pract. 2026 Feb 22. doi: 10.1177/17504589261418823. PMID: 41723588.

Hussein MA et al. Improving operating theatre utilization time in New Najran General Hospital using lean six sigma approach. South East European Journal of Public Health. 2025. doi: 10.11567/seejph.2025.1.12.

Al-Araidah O et al. A study of operating theatre utilization in a public hospital in Jordan. International Journal of Planning and Scheduling. 2010;1(1):43-56.