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Year : 2016  |  Volume : 34  |  Issue : 2  |  Page : 259--260

Application of lean principles/ lean management can improve

P Arora 
 Department of Hospital Administration, PGIMER, Chandigarh, India

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P Arora
Department of Hospital Administration, PGIMER, Chandigarh

How to cite this article:
Arora P. Application of lean principles/ lean management can improve.Indian J Med Microbiol 2016;34:259-260

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Arora P. Application of lean principles/ lean management can improve. Indian J Med Microbiol [serial online] 2016 [cited 2019 Oct 18 ];34:259-260
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Dear Editor,

I read with interest the article "Is non-woven fabric a useful method of packaging instruments for operation theatres in resource constrained settings?", since improvement of the quality of sterilisation services is of paramount importance. [1] Authors have rightly pointed out that the cost effectiveness will depend on the study setting. However, in my view two aspects of costing need further elaboration that is, how was the cost of resterilisation process (Indian Rupees [INR] 522.41 for woven and INR 110.09 for non-woven) arrived at and why were these different if everything else other than packing material was same. It would also be interesting to know the indication of resterilisation. Since the microbiological analysis was not performed/mentioned, it is fair to assume that the decision to process the surgical packet again was time dependent. It may be appropriate in settings where absolute clean storage conditions cannot be provided, but it is also acknowledged that shelf life is probably activity dependent rather than time dependent. [2] The rates of resterilisation can be decreased by minimising the unnecessary handling of sterile products and applying the principles of lean management so as to reduce the number of excess packs in circulation and avoid superfluous handling of sterile packets. [3]

Notwithstanding the debate about cost effectiveness of different materials for packing, the costlier material that has higher shelf life has application for packing sterile products as a part of disaster preparedness, especially in public sector hospitals in India. This is because a pre-estimated amount of inventory including sterile surgical sets/packets and consumables have to be kept ready and in reserve to be used in exigencies. [4] Any increase in shelf life, even at higher cost will reduce the need for frequent resterilisation and improve the efficiency.

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1Devadiga GS, Thomas VM, Shetty S, Setia MS. Is non-woven fabric a useful method of packaging instruments for operation theatres in resource constrained settings? Indian J Med Microbiol 2015;33:243-7.
2Barker CS, Soro V, Dymock D, Fulford M, Sandy JR, Ireland AJ. Time-dependent recontamination rates of sterilised dental instruments. Br Dent J 2011;211:E17.
3Johnson PM, Patterson CJ, O′Connell MP. Lean methodology: An evidence-based practice approach for healthcare improvement. Nurse Pract 2013;38:1-7.
4National Disaster Management Guidelines-Hospital Safety (draft). New Delhi: National Disaster Management Authority; 2013. Available from: [Last cited on 2015 Jun 11].