Practical thinking on OR operations, Lean Six Sigma methodology, and healthcare leadership — drawn from real experience on the floor and in the boardroom.
Most hospitals treat FCOTS failures as a scheduling issue. In reality, they are accountability and systems failures that require a fundamentally different response from leadership. When blame-shifting becomes the default response to late first cases, it's a signal that the underlying system design — not the individuals — is the problem. I break down how DMAIC root cause analysis reveals what's actually driving the delays, and what sustainable FCOTS improvement actually requires from those at the top.
Read Article →Preference card inaccuracy is one of the most overlooked cost drivers in perioperative services — and one of the highest-ROI problems you can solve. Hospitals assume it's an administrative nuisance. It's actually a supply chain failure, a labor cost driver, and when it results in missing instruments, a patient safety issue. I walk through what inaccuracy costs per case, the cascade effect it produces, why cards go stale, and the governance structure that fixes it — including a practical step you can take this week.
Read Article →The OR–SPD relationship is often adversarial. That tension costs case time, staff morale, and patient safety — and it's entirely structural. Different supervisors, different metrics, no shared accountability: those are design problems, not personality problems. I cover why the handoff gap exists, what happens when tray defects hit the OR without a feedback loop, the T-15 huddle concept, the case-signout defect form, and how closing the loop changes the culture — not just the process.
Read Article →A lot of healthcare leaders have heard of Lean Six Sigma but aren't sure what it looks like applied to real OR problems. Here's what it actually involves. I demystify DMAIC in a perioperative context — why it's the right framework for complex OR problems, what the Measure phase looks like with EPIC data including DPMO and Sigma level calculation, what the Analyze phase reveals that gut-feel management never would, and what Control means when your "factory" is a 12-room OR running 65 cases a day.
Read Article →