Workflow optimization in a clinical laboratory using Lean management principles in the pre-analytical phase

Abstract

BACKGROUND: The application of the Lean methodology in clinical laboratories can improve workflow and user satisfaction through the efficient delivery of analytical results. The purpose of this study was to optimise delivery times of the test results at a clinical laboratory, using Lean management principles in the pre-analytical phase.
 METHODS: A prospective study with a quasi- experimental design was implemented. Staff functions were restructured and sample flows were modified. Delivery times of clinical results (glucose and haematocrit) from the Medicine and Adult Emergency services for years 2017 and 2018 were compared.
 RESULTS: A reduction (p < 0.05) in turnaround times in the delivery of glucose test results at the adult emergency service was observed (84 to 73 min, 13%, pre and post). In addition, there was a non-significant reduction in the turnaround times for glucose (Medicine) and haematocrit in both services. In the analytical and post-analytical phase (not intervened), an increase in turnaround times was observed in some cases.
 CONCLUSIONS: Other studies have indicated that the application of the Lean methodology in clinical laboratories improves workflow, increasing effectiveness and efficiency. This study showed an improvement in the delivery time of test results (glucose – Emergency), giving rise to a culture of cooperation and continuous improvement. It would, however, be essential to address the management model integrating the analytical and post-analytical phases.

Externalities of Lean Implementation in Medical Laboratories. Process Optimization vs. Adaptation and Flexibility for the Future

“…Staff resistance to change is one of the main barriers, along with lack of support from management and financial constraints. On the opposite side, Letelier [ 25 ] et al mentioned that results were achieved with minimum financial investment (except for the structural modifications). Another case study in a tertiary care pediatric hospital in Nova Scotia, Canada, did not require high financial or time investment, as mentioned by Geerlinks et al [ 31 ].…”

“…Letelier et al [ 25 ] mentioned that implementation contributed to the emergence of a culture of continuous improvement in the laboratory. Still, analyzing all the selected articles, we can conclude that too little emphasis was placed on the effects that Lean has on organizational culture and on improving relationships within work teams and focused only on quantitative performance measurement, specifically on the analysis of key performance indicators.…”

Evaluation of sample rejection rate in clinical biochemistry laboratory before and after implementation of six-sigma methodology

“…In the recent years, six-sigma has been successfully employed to evaluate the quality of different phases of clinical laboratory from preanalytical and analytical to post-analytical areas. [10][11][12][13][14] Studies have been done to evaluate the rate of sample rejection in biochemistry laboratory, but few discuss the improvement after implementation of corrective measures and fewer have used six-sigma as a process improvement tool.…”