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; 6648 data) 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.
Uvod: Primena Lean metodologije u kliničkim laboratorijama može da poboljša protok i funkcionisanje efikasnosti laboratorije u svrhu dobijanja analitičkih rezultata. Svrha ovog proučavanja je da se optimizuje vreme isporuke rezultata ispitivanja u kliničkoj laboratoriji primenom principa Lean-menadžmenta u pre-analitičkoj fazi.
Metode: Primenjena je prospektivna studija kvazi-eksperimentalnog modela. Funkcionisanje osoblja je prilagođeno i pojednostavljen je protok uzoraka. Vreme isporuke kliničkih rezultata (glukoze i hematokrita) iz Kliničkog i Urgentnog odeljenja za odrasle u periodu od 2017 do 2018.
Rezultati: Nađeno je smanjenje (p < 0,05) obrtnog vremena pri isporuci rezultata za glukozu u odeljenje urgentne službe (84 do 73 min, 13%, pre i post). Dodatno nije bilo značajnog smanjenja obrtnog vremena za izdavanje rezultata za glukozu i hematokrit za kliničko odeljenje. U analitičkoj i post-analitičkoj fazi uočeno je izvesno povećanje obrtnih vremena u izvesnim slučajevima.
Zaključak: Druga proučavanja koja su primenjivala Lean metodologiju u kliničkim laboratorijama ukazuju na poboljšanje protoka, efikasnosti i efektivnosti. Ovo izučavanje ukazuje na poboljšanje vremena isporuke rezultata ispitivanja (glukoza - hitnoj službi), ukazujući na stalnu mogućnost poboljšanja. Potrebno je ukazati da je neophodna primena menadžmenta na integrisanu analitičku i post-analitičku fazu.
Keywords: Lean methodology; clinical laboratory; preanalytical phase.
2021 Pablo Letelier, Neftalí Guzmán, Gustavo Medina, Luis Calcumil, Pamela Huencho, Jonathan Mora, Francisco Quiñones, Jorge Jara, Cristóbal Reyno, Jorge G. Farías, Belén Lisandra Herrera, Priscilla Brebi, Ismael Riquelme, Martín Andrés San, published by CEON/CEES.