Lean healthcare for reduction of the setup time in cardiac surgery: an analysis in a private hospital


  • Nicole Cristina Costa
  • Fabiano Oscar Drozda
  • Silvana Pereira Detro
  • Marcos Augusto Mendes Marques


Lean Healthcare, SMED, Diagrama de Ishikawa, setup, centro cirúrgico


Reducing processes setup time is one of the main purposes of Lean Manufacturing. This work has the goal to present an application of the combination of two Lean tools, the Ishikawa Diagram and the SMED methodology, to optimize the setup time between cardiac surgeries in the operating room of a private hospital. Initially, setup activities were mapped by drawing up a flowchart, and later a brainstorming session for the Ishikawa Diagram was done with the team to identify the possible causes of the delays. Following, the first two stages of the SMED (Single Minute Exchange of Die) methodology were applied, proposing the conversion of internal to external setup for the given activities. Although the hospital did not adopt the proposals while this study was built due to another project’s prioritization, a simulation of the new setup times showed that the total time reduction would be up to 20%. This corresponds to a capacity improvement of two cardiac surgeries per month, and in the absence of demand for this specialty, vacancies for other types of surgeries would also be opened, bringing gains in productivity and in the number of patients assisted.