• David Reznick, Lora Niazov, Eric Holizna, and Allan Siperstein.
• Endocrine Surgery Department at the Cleveland Clinic, Cleveland, OH. Electronic address: reznicd@ccf.org.
• Surgery. 2014 Oct 1;156(4):752-8.

PurposeThe goal of this study was to examine how industrial process improvement techniques could help streamline the preoperative workup.MethodsLean process improvement was used to streamline patient workup at an endocrine surgery service at a tertiary medical center utilizing multidisciplinary collaboration. The program consisted of several major changes in how patients are processed in the department. The goal was to shorten the wait time between initial call and consult visit and between consult and surgery.ResultsWe enrolled 1,438 patients enrolled in the program. The wait time from the initial call until consult was reduced from 18.3 ± 0.7 to 15.4 ± 0.9 days. Wait time from consult until operation was reduced from 39.9 ± 1.5 to 33.9 ± 1.3 days for the overall practice and to 15.0 ± 4.8 days for low-risk patients. Patient cancellations were reduced from 27.9 ± 2.4% to 17.3 ± 2.5%. Overall patient flow increased from 30.9 ± 5.1 to 52.4 ± 5.8 consults per month (all P < .01).ConclusionUtilizing process improvement methodology, surgery patients can benefit from an improved, streamlined process with significant reduction in wait time from call to initial consult and initial consult to surgery, with reduced cancellations. This generalized process has resulted in increased practice throughput and efficiency and is applicable to any surgery practice.Copyright © 2014 Elsevier Inc. All rights reserved.

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