Dr. Afonso, Gastroclinic, Portugal: Optimizing the Operating Room for bariatric surgery 

This is the second article in our series about Dr. Afonso, a renowned gastroenterologist and specialist in endoscopic treatments for obesity. 

Dr. Afonso has been collaborating with DEO.care over the past two years. In the first article, we explored how he is leveraging DEO.care’s process digital twin to set up his new private Gastroclinic and integrate the latest innovations in operating room (OR) process optimization. You can read it here. 

In this second article, we focus on the results of Dr. Afonso’s efforts to integrate DEO.care’s cutting-edge solutions into his original clinic, Clinica de Beloura. By optimizing the clinic’s processes, he has laid a strong foundation to ensure the most efficient workflow in his new Gastroclinic from the very beginning. 


As outlined in the first article of this series, Dr. Afonso collaborated with DEO.care to capture best practices in his current operating room at Clinica de Beloura to understand where there might be improvement opportunities to take to the OR in his new focus clinic, the Gastroclinic. 

DEO.care’s data analysis identified opportunities for improvement in the preparation processes because there was no synchronization of patient and material flow, due to late patient arrivals and pre-anesthesia variability. The analysis also identified opportunities to shorten turnover time between patients by simplifying cleaning activities and task allocations between one patient leaving and the next one entering. 

DEO.care used its process digital twin technology to perform simulations that identified how the proposed improvements could enhance OR throughput. Using the simulations, DEO.care predicted that implementing changes such as parallelizing patient and material preparation and reducing turnover could allow Dr. Afonso to perform one additional endoscopic sleeve gastroscopy (ESG) surgery in the OR per day, as shown in Figure 1 below.

Figure 1. Simulations of the increase of OR throughput by implementing the best practices. 


Dr. Afonso successfully performed the optimizations as proposed by DEO.care’s simulations in the Clinica de Beloura OR. Post-implementation measurements found significant improvements. Patient and material preparation processes ran in parallel, idle times were reduced, a new surgical technique was introduced, and turnover time was reduced by more than 50%, as shown in Figure 2 below. 

Figure 2. Post-implementation measurements demonstrated successful implementation 

Those process optimizations enable Dr. Afonso to treat one additional patient during his operating hours, while maintaining his standards of excellent quality of care. 

The data demonstrated that Dr. Afonso and his team are now able to consistently perform the OR processes, with a case-to-case variability of 14 minutes compared to the initial 40 minutes variability, as shown in Figure 3 below.

Figure 3. Post-implementation measurements showed Increased process consistency 

What’s Next 

DEO.care empowered Dr. Afonso and his team to implement effective changes, optimizing their OR processes. Now, Dr. Afonso has the roadmap and evidence to take to his newly built clinic, paving the way to be able to meet growing patient demand, while enhancing the quality of patient care. 

Dr. Afonso and his OR team opened the focus clinic in early 2024, and DEO.care will work with him later this year to measure his success in achieving operational excellence at this clinic.