Improving operating room efficiency through lean thinking: a multi-criteria decision-making approach

Purpose This study aims to support waste reduction in hospital operating rooms by identifying performance indicators and waste categories that should be prioritized for intervention, based on their criticality and interrelationships. The goal is to enhance efficiency and effectiveness in healthcare operations by aligning with lean thinking principles. Design/methodology/approach A multi-criteria decision-making model is developed by integrating Fuzzy Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) Class and Fuzzy decision-making trial and evaluation laboratory (DEMATEL) methods. Fuzzy TOPSIS Class is applied to evaluate and classify 32 operating room (OR) performance indicators and 21 waste types according to expert-assessed criticality levels. Subsequently, Fuzzy DEMATEL is used to analyse causal relationships among the most critical indicators and wastes. A real-world case study based on expert judgement is used to validate the approach. Findings The model enables the identification of high-priority OR performance indicators and waste types and maps their interdependencies through a visual cause-and-effect matrix. This matrix provides insights into the influence structure between performance indicators and waste categories, supporting informed and targeted decision-making in OR management. Originality/value This study contributes to healthcare operations management by combining Fuzzy TOPSIS Class and Fuzzy DEMATEL in a novel way to address waste reduction in ORs. The integrated model offers a systematic, expert-informed approach for prioritizing indicators and wastes, as well as understanding their interrelations, providing actionable guidance for the development of targeted action plans to enhance OR performance through lean thinking.