A 383% Increase in Testing Efficiency in a Diagnostics Molecular Lab: LEAN Work Design and Continuous Process Improvements Are Critical for Maintaining Steady Expansion of Services and Short Turn-Around Times.
Milena Cankovic, Lisa Whiteley, Joanne Beher, Don Lubensky, Richard J Zarbo, Dhananjay Chitale. Henry Ford Hospital, Detroit, MI
Background: With new cancer biomarkers and targeted therapies growing in number, the demand for molecular oncology lab services has been increasing. In 2006, faced with the necessity to bring on new tests and increase revenue for sustainability, our laboratory made an effort to aggressively eliminate non-value added waste and promote LEAN work practices. Standard activities, direct connections and pathways, and continuous improvement and worker empowerment were focused on. The aim of this study was to evaluate effectiveness and sustainability of LEAN in a laboratory environment with monitoring of total volumes and turn around time (TAT) for clinical tests as the ultimate indicator of lab efficiency and customer satisfaction.
Design: Management and staff received LEAN training in May of 2006 as part of a department-wide effort. All processes, inventories, and customer-supplier connections were evaluated. Specimen delivery, test ordering, reporting of results, inventory, and assay validations were standardized. Teaching modules were developed to educate suppliers (support personnel, nursing) and customers (physicians). A minimum of 2 process improvements continue to be implemented each month based on PDCA (Plan, Do, Check, Act) principles. Data was collected before and after the implementation of above initiatives which included number of tests, samples, time of receipt and completion of testing for TAT calculation.
Results: Tests offered from rose from 2 in 2004 to 30 in 2009 while the number of clinical samples rose from 220 in 2004 to 1500+ in 2010.
Number of molecular genotyping tests vs average turn around times from years 2004 to 2009.
Conclusions: Over a 4 year period (2006-2009) our laboratory maintained short TAT (1.5-3 business days) with constant staffing levels while significantly increasing the number of tests offered and the samples processed. Additionally, validation studies were done for individual tests before offering them clinically. Creating, structuring and sustaining a culture of continuous improvement allowed us to reduce non-value added waste and allocate resources towards growth and expansion, employee engagement, and greater patient/ clinician satisfaction.
Category: Quality Assurance
Monday, February 28, 2011 1:00 PM
Poster Session II # 213, Monday Afternoon