Paper Title
Applying Lean Six Sigma Improvement Methodology to Increase Catheterization Laboratory Efficiency

Abstract
Coronary diseases have increasing trend in many countries. Considering increasing number of patients and cases, improvement projects are getting crucial at catheterization laboratories. We took a close look to our catheterization laboratory operations from patient admission until discharge. We have initiated lean six sigma implementation at our catheterization laboratory starting with January 2013. This study shows the plans and results between June 2013 and December 2014. As a basis of this study, we have measured the time spent by patients at each processes from admission until discharge in the second half of 2013 during catheterization laboratory operations. We realized patient-waiting time, late start of first procedures and procedure cancellations are the biggest problems. We made root cause analysis and in parallel patient satisfaction surveys were also pointing out dissatisfaction was dramatically increased due to long waiting times. We worked on improving process flow, making it smoother and steadier through work stream, and eliminating waste in years continuously with a plan. Procedure types remained same but number of procedures performed was increased. Wastes in the processes were dramatically decreased; we saved time and created capacity into current catheterization laboratory operations by using continuous improvement techniques with our staff. Although we have employed two non-clinical staff titled �catheterization laboratory service manager", and �material analyst�, number of patients treated in the same catheterization laboratory was increased in 2014 comparing with 2013. Keywords- Catheterization laboratory, Healthcare, Lean six sigma, Operational efficiency, Patient pathway, Toyota