Abstract
This study investigated whether value stream mapping (VSM)-guided optimization of enhanced recovery after surgery (ERAS) nursing could improve nursing efficiency and reduce waiting time in geriatric orthopedic patients. A non-synchronous controlled study included 105 elderly orthopedic inpatients. The control group (n = 53) received conventional ERAS nursing, whereas the experimental group (n = 52) received an optimized nursing package developed after VSM-based workflow diagnosis, including centralized preoperative examination scheduling, standardized process management, visual dashboards, multidisciplinary collaboration, and structured materials management. Nursing efficiency, waiting time, early postoperative recovery indicators, complications, and satisfaction were compared. Process efficiency was higher in the experimental group than in the control group (15.15% ± 1.71% vs 8.01% ± 1.34%, p < 0.001). Total waiting time was shorter in the experimental group (12.54 ± 2.36 h vs 28.57 ± 4.45 h, p < 0.001). Preoperative preparation time, first ambulation time, and hospital stay were also reduced, and the 72 h pain score, first flatus time, joint range of motion, and satisfaction improved. Value stream mapping-guided ERAS nursing optimization may improve perioperative process efficiency and early recovery in geriatric orthopedic patients.