A Framework to Find Flow Disruptions in the Operating Rooms' Consumable Supplies

Abstract Background Operating room consumables play a very vital role in the surgery process. There are some disruptions in their flow that can affect the whole process of surgery. Finding these disruptions is the first step to eliminate their negative effects. Although previous studies have examined workflow disruptions in the operating rooms, there are few studies focusing specifically on the operating room consumables' workflow and examining the process thoroughly with a framework. Methods This study introduces a framework to find disruptions that directly or indirectly may affect the flow of operating room consumables. The framework consists of four steps: 1) mapping the operating room consumables flow, 2) finding disruptions in terms of operating room pauses due to shortage of items and categorizing them, 3) classifying the disruptions and finding their sources, and 4) taking these disruptions as risk factors and rating them using risk management approach. To achieve this objective, 20 surgical operations (mainly kidney and general surgeries) were observed at two hospitals in Tehran over a five-month period from May 10 until October 10, 2018. By reviewing the literature and field observations, 11 disruptions were extracted and then assessed using the supply chain risk score. Results We applied the proposed framework to the two studied hospitals and categorized the disruptions in the flow of operating room consumables in three different categories: human factors, policies, and external factors. After prioritizing the disruptions, "inappropriate recording points" related to inventory control issues was found to be the most effective and frequent issue that affected consumables flow. Conclusions Well understanding the disruptions in the flow of consumables is very important because finding their sources are the first step to eliminate or decrease them. This paper presents a framework to identify the disruptions in the flow of operating room consumables, which can be further used to find the savings in terms of time and money after implementing corrective actions.