• Brandon Lum, Hong Muay Png, Hock Lan Yap, Cindy Tan, Bixian Sun, and Yen Hoon Law.
• Quality Improvement and Patient Experience, National University Hospital, Singapore, Singapore.
• BMJ Open Qual. 2019 Jan 1; 8 (3): e000583.

AbstractThe theatre sterile surgical unit (TSSU) is an essential core to support the operating theatres in National University Hospital. Surgical instruments and supplies are processed, packaged and sterilised safe for surgical procedures. A rapid improvement event adopting lean methodology was conducted with the TSSU team to streamline the workflows in this area. The project aimed to identify TSSU work processes that can be streamlined or automated, improving timeliness while identifying potential for role redesign and maximising human resource. The team successfully implemented initiatives to eliminate unnecessary workflows and achieve workload levelling. This reduced instrument processing time by 5%, while replenishment times of surgical supplies to the operating theatres decreased by 29%. The team successfully redesigned the TSSU job roles, converting several nursing staff to non-nursing roles. Long-term initiatives such as the use of disposables and an improved theatre instrument management system were planned for as well. Initiatives derived from this project can be spread to other sterile supply units within the hospital, further optimising the use of resources at a hospital level. The concept of role redesign was found to be applicable to healthcare, highlighting its potential in other areas of the hospital.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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