Objectives: To implement Lean principles to accommodate expanding volumes of gastrointestinal biopsies and to improve laboratory processes overall.
Design: Our continuous improvement (kaizen) project analyzed the current state for gastrointestinal biopsy handling using value-stream mapping for specimens obtained at a 487-bed tertiary care pediatric hospital in Dallas, Texas. We identified non-value-added time within the workflow process, from receipt of the specimen in the histology laboratory to the delivery of slides and paperwork to the pathologist. To eliminate non-value-added steps, we implemented the changes depicted in a revised-state value-stream map.
Results: Current-state value-stream mapping identified a total specimen processing time of 507 minutes, of which 358 minutes were non-value-added. This translated to a process cycle efficiency of 29%. Implementation of a revised-state value stream resulted in a total process time reduction to 238 minutes, of which 89 minutes were non-value-added, and an improved process cycle efficiency of 63%.
Conclusions: Lean production principles of continuous improvement and waste elimination can be successfully implemented within the clinical laboratory.
Keywords: Lean principles; anatomic pathology workflow; gastrointestinal biopsy handling; histology laboratory; laboratory processes; process improvement.