Using Lean principles to optimise inpatient phlebotomy services

Le, Rachel D.; Melanson, Stacy E.F.; Santos, Katherine; Paredes, José D.; Baum, Jonathan M.; Goonan, Ellen M.; Torrence-Hill, Joi N .; Gustafson, Michael L.; Tanasijevic, Milenko J.

doi:10.1136/jclinpath-2013-202097

Cited by 8 publications

(10 citation statements)

References 6 publications

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“…Phlebotomy units are one of the most important parts of a clinical laboratory, and any mistakes and delays in this part of the lab affect the other parts. Improved timeliness of blood draws and decreased error rates can be achieved using Lean principles . Clinical laboratories are very complex, dynamic organizations that always need to improve the quality of testing and meet stringent guidelines, while trying to decrease costs.…”

Section: Discussionmentioning

confidence: 99%

Lean six sigma methodologies improve clinical laboratory efficiency and reduce turnaround times

İnal

Öztürk

Kibar

et al. 2017

Clinical Laboratory Analysis

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Results:The pre-analytical process in the reception area was improved by eliminating 3 h and 22.5 min of non-value-adding work. Turnaround time also improved for stat samples from 68 to 59 min after applying Lean. Steps prone to medical errors and posing potential biological hazards to receptionists were reduced from 30% to 3%. Conclusion:Successful implementation of Lean Six Sigma significantly improved all of the selected performance metrics. This quality-improvement methodology has the potential to significantly improve clinical laboratories. K E Y W O R D Smedical error, pre-analytical, process flow, quality improvement, quality management, workflow

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Section: Discussionmentioning

confidence: 99%

Lean six sigma methodologies improve clinical laboratory efficiency and reduce turnaround times

İnal

Öztürk

Kibar

et al. 2017

Clinical Laboratory Analysis

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“…There is no specific time limit for CQI implementation, although there is a general consensus that a cycle of CQI should be relatively short [35]. For instance, a CQI implementation took 2 months [42], 4 months [50], 9 months [51,52], 12 months [53][54][55], and one year and 5 months [49] duration to achieve the desired positive outcome, while bi-weekly [47] and monthly data reviews and analyses [44,48,56], and activities over 3 months [57] have also resulted in a positive outcome.…”

Section: Operationalizing Continuous Quality Improvementmentioning

confidence: 99%

A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact

Endalamaw,

Khatri,

Mengistu

et al. 2024

BMC Health Serv Res

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Background The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI. However, comprehensive evidence regarding the diverse facets of CQI in healthcare has been limited. Our review sought to comprehensively grasp the conceptualization and principles of CQI, explore existing models and tools, analyze barriers and facilitators, and investigate its overall impacts. Methods This qualitative scoping review was conducted using Arksey and O’Malley’s methodological framework. We searched articles in PubMed, Web of Science, Scopus, and EMBASE databases. In addition, we accessed articles from Google Scholar. We used mixed-method analysis, including qualitative content analysis and quantitative descriptive for quantitative findings to summarize findings and PRISMA extension for scoping reviews (PRISMA-ScR) framework to report the overall works. Results A total of 87 articles, which covered 14 CQI models, were included in the review. While 19 tools were used for CQI models and initiatives, Plan-Do-Study/Check-Act cycle was the commonly employed model to understand the CQI implementation process. The main reported purposes of using CQI, as its positive impact, are to improve the structure of the health system (e.g., leadership, health workforce, health technology use, supplies, and costs), enhance healthcare delivery processes and outputs (e.g., care coordination and linkages, satisfaction, accessibility, continuity of care, safety, and efficiency), and improve treatment outcome (reduce morbidity and mortality). The implementation of CQI is not without challenges. There are cultural (i.e., resistance/reluctance to quality-focused culture and fear of blame or punishment), technical, structural (related to organizational structure, processes, and systems), and strategic (inadequate planning and inappropriate goals) related barriers that were commonly reported during the implementation of CQI. Conclusions Implementing CQI initiatives necessitates thoroughly comprehending key principles such as teamwork and timeline. To effectively address challenges, it’s crucial to identify obstacles and implement optimal interventions proactively. Healthcare professionals and leaders need to be mentally equipped and cognizant of the significant role CQI initiatives play in achieving purposes for quality of care.

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“…It can also be a general due date, where a test result is considered timely if its TAT is less than a predefined TAT goal [25]. Timeliness of subprocesses may be considered as well, for example the timeliness of phlebotomy [26].…”

Section: Timelinessmentioning

confidence: 99%

“…Some studies consider the on-time percentage [26], while others consider the total or the average tardiness [27].…”

Section: Timelinessmentioning

confidence: 99%

A critical review of laboratory performance indicators

Tsai

Tintu

Demirtaş

et al. 2019

Critical Reviews in Clinical Laboratory Sciences

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Healthcare budgets worldwide are under constant pressure to reduce costs while improving efficiency and quality. This phenomenon is also visible in clinical laboratories. Efficiency gains can be achieved by reducing the error rate and by improving the laboratory's layout and logistics. Performance indicators (PIs) play a crucial role in this process as they allow for performance assessment. This review aids in the process for selecting laboratory PIs-which is not trivial-by providing an overview of frequently used PIs in the literature that can also be used in clinical laboratories. We conducted a systematic review of the laboratory medicine literature on PIs. As the testing process in clinical laboratories can be viewed as a production process, we also reviewed the production processes literature on PIs. The reviewed literature relates to the design, optimization or performance assessment of such processes. The most frequently cited PIs relate to pre-analytical errors, timeliness, resource utilization, cost, and the amount of congestion. Their citation frequency in the literature is used as a proxy for their importance. PIs are discussed in terms of their definition, measurability and impact. The use of suitable PIs is crucial in production processes, including clinical laboratories. By also reviewing the production processes literature, additional relevant PIs for clinical laboratories were found. The PIs in the laboratory medicine literature mostly relate to laboratory errors, while the PIs in the production processes literature relate to the amount of congestion in the process.

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Using Lean principles to optimise inpatient phlebotomy services

Cited by 8 publications

References 6 publications

Lean six sigma methodologies improve clinical laboratory efficiency and reduce turnaround times

Lean six sigma methodologies improve clinical laboratory efficiency and reduce turnaround times

A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact

A critical review of laboratory performance indicators

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