<h3>Background</h3> Cardiac surgery for different patient composition with pertinent role of anesthesia behaves in a different pattern with respect to process, duration and outcome of surgery. The time required for perioperative and surgical activities influence the patient's total hospital stay. <h3>Objective</h3> To improve the time-based practices for cardiac surgeries in conjunction with close orchestration as a part of perioperative system particularly specific surgical duration, length of intensive care stay and hospital stay. <h3>Design</h3> A retrospective observational study was conducted at the tertiary cardiac surgery hospital. Sixty-eight adult cardiac surgery patients were included from 1st January 2022 to 15th February 2022. Thirteen patients were excluded on the basis of missing data, inadequate record and pediatric patients. <h3>Method</h3> The Six Sigma- DMAIC approach was followed, which consists of five steps namely, Define, Measure, Analyze, Improve and Control. It was possible to understand the pattern of variation for time durations such as surgical time and total hospital stay. This approach revealed that important factors to become less important and so-called less important factors combined with minor factors are significant. <h3>Results</h3> OR-Operation Room, LOSITU-Length of stay in Intensive Care Unit, LOSH-Length of stay in Hospital. Patient compositions, surgical teams and processes hardly could throw light to influence LOSITU and LOSH. However, LOSH significantly correlates to LOSITU as evident from the model: Pearson correlation=0.536 (p-value<0.001). LOSH (Days)=8.924+0.628 LOSITU (Days). LOSITU varies with a non-normal pattern but with a clear mode of 4 days, which means LOSITU of 4 days can be optimal. The durations at different stages could show pattern in terms of results consolidated as under: The LOSITU depends both OR time and ventilation time; a model is developed to predict LOSITU (Days): LOSITU (Days)=7.32-1.237 Total OR time (Min)+0.2552 Ventilation (Hrs). However, the same is not true for LOSH. The model derived for LOSH could offer the revelations as under: LOSH (Days)=14.43-0.970 OR time (Min)+0.1694 Ventilation (Hrs). Internally grafting time also correlates significantly to OR time. <h3>Conclusion & Recommendations</h3> Out of 41 factors suspected to influence LOSITU and LOSH only 3 factors could contribute significantly. LOSH significantly correlates to LOSITU. LOSITU and LOSH can be reduced to 4 days and 11 days respectively except in high-risk cases. LOSITU has to be considered by keeping reasonable OR Time so that Ventilation Time is minimal to yield optimized LOSH. As per the model, OR Time can be predicted and accordingly pre-empt the ventilation time to decide LOSITU. However, the same is not true for LOSH. So, surgical activities are more predictable to know LOSH. Which in turn implies that LOSH is influenced by non-medical issues such as administration and insurance policy. So serious research should take place to unearth the latent important factors and repeat the model of this study to derive better confidence on results.