Eyeglasses are made through a production process. Lean and Six Sigma are used to improve quality in this and many other aspects of vision care, including seeing patients and surgery. We’ll look at applications from Australia, USA: Indiana, Jordan, and Turkey. Then we’ll read some general recommendations for applying Kaizen and 5S in eye care practices. Finally, we’ll view a video on how eyeglasses are made.


Lean Six Sigma Used to Improve Outpatient Ophthalmology Clinic Efficiency: Australia

In an article titled “Using Lean Six Sigma techniques to improve efficiency in outpatient ophthalmology clinics,” authors Andrew W. Kam and others discuss the impact of Lean Six Sigma on reducing patient wait times and increasing service capacity.

The article includes:

  • Eye Clinic Patient Flow and Associated Proportion of Time Spent
  • Pre vs. Post-Implementation Appointment Types
  • Pareto Chart of Root Causes of Issues
  • Histogram of Feb-June 2018 Appointment Times
  • Histogram of Feb-June 2019 Appointment Times
  • Histogram of Feb-June 2018 Patient-in-Clinic Times
  • Histogram of Feb-June 2019 Patient-in-Clinic Times
You can read the article here.


Lean Six Sigma Used to Improve Outpatient Ophthalmology Clinic Efficiency: USA: Indiana


In a paper titled “Lean Six Sigma techniques to improve ophthalmology clinic efficiency,” authors Thomas A. Ciulla and others discuss the use of Lean Six Sigma to decrease patient flow time.

The paper includes:

  • Seven Forms of Waste in Retinal Care
  • Fishbone Diagram for Long Patient Throughput Time
  • Retina Clinic Process Flows
    • New Patient – Complex
    • New Patient – Intermediate
    • Established Patient – Intermediate
    • Established Patient – Testing and Treatment Only
    • Established Patient – Treatment Only
  • Pareto Charts of Patient Times by Task Type
    • Aggregate and Average
  • Histograms of Initial vs. Final Total Visit Time

Follow-up analysis showed a  statistically significant decline in mean patient flow time by 18%.

You can access the paper here.


Lean Six Sigma Tools Applied to Ophthalmology Surgery Length of Stay: Jordan


In a case study titled “Application of Lean Six Sigma tools to minimize the length of stay for ophthalmology day case surgery,” authors Nabeel Mandahawi and others discuss using Lean tools to streamline processes and enhance productivity a hospital’s ophthalmology department.

The case study includes:

  • SIPOC for Day Case Operations
  • Swim Lane Process Map for Day Case Surgery
  • Sample of Observed Times for Each Department
  • Current State Value Stream Map
  • Pareto Chart of Insurance Companies’ Impact on Delays
  • Fishbone Diagram of Pre-Operation Delays
  • Priority Matrix

Improvements expect an approximate potential reduction of 48% in patients’ length of stay at the hospital.

You can read the case study here.


Using Six Sigma to Reduce the Number of Complications During and After Eye Surgery: Turkey


In a paper titled “Development of a Six Sigma Infrastructure for Trabeculectomy Process, " Can Öztürker and others discuss using Six Sigma to reduce complications during and after eye surgery.

NOTE: Trabeculectomy is a type of glaucoma surgery performed on the eye that creates a new pathway for fluid inside the eye to be drained to prevent the worsening of vision loss by lowering eye pressure.

The paper includes:

  • SIPOC Table for Trabeculectomy Surgery
  • Table of Complications Experienced
  • Source of Complications
  • Root Causes of Complications
  • Frequencies of Complications
  • FMEA for Complications

The Appendix to the paper includes preventative measures for the twelve types of complications.

You can access the paper here.


Applying Kaizen and 5S in an Ophthalmology Practice


In a presentation titled “Changing the Course of Your Practice Through Kaizen and the 5S Approach,” author Steve Alexander, an experienced optician and eye care consultant, discusses Kaizen and 5S specifically for eye care practices.

You can view Steve’s presentation here.


How Eye Glasses are Made


See how eyeglasses are made in this video from How It’s Made.

You can watch the video here.


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