Endovascular aneurysm repair delivery redesign leads to quality improvement and cost reduction.

Objective: Endovascular aneurysm repair (EVAR) is now a mainstay of therapy for abdominal aortic aneurysm, although it remains associated with significant expense. We performed a comprehensive analysis of EVAR delivery at an academic medical center to identify targets for quality improvement and cost reduction in light of impending health care reform.

Methods: All infrarenal EVARs performed from April 2011 to March 2012 were identified (N = 127).

Lean principles optimize on-time vascular surgery operating room starts and decrease resident work hours.

Objective: Lean process improvement techniques are used in industry to improve efficiency and quality while controlling costs. These techniques are less commonly applied in health care. This study assessed the effectiveness of Lean principles on first case on-time operating room starts and quantified effects on resident work hours.