Implementation of Lean Methods To Improve Histotechnology Productivity
Heather S Currens, Stephen S Raab. Eastern Health Authority, St. John's, NL, Canada; University of Washington, Seattle, WA
Background: Lean methods have been increasingly incorporated into healthcare institutional strategies to maximize efficiencies, improve financials, and reduce error. We examined the effectiveness of these methods in improving the productivity of histotechnology services.
Design: We evaluated the turn-around times (TAT) for the processing of surgical tissue blocks over a 5 month period. To affect a reduction in the backlog of uncut blocks and to achieve a 24 hour processing TAT, we employed Lean methods, including creating a visual workplace; 5S of the laboratory; introduction to Toyota work principles; workspace redesign and standardization; employee engagement in work redesign; and assessment of task staffing requirements. Lean Implementation specialists performed root cause analysis to investigate methods of reducing TAT. Pathology residents instituted quality improvement studies to identify areas of over-blocking of surgical specimens.
Results: Initially, we found a backlog of 1989 surgical specimen blocks. Productivity of technologists ranged from 30 slides per day to 150 slides per day with a staff of 14 FTEs. Within the first month, the 5S of the lab created four additional cutting stations that produced a more conducive work area. Employee education encouraged participation from the frontline staff in the evaluation of factors contributing to the backlog of work and in workspace standardization. Reassessment of task staffing requirements removed technologists from 2 assignments that were transferred to laboratory assistants thereby freeing up additional time to cut blocks. Improvement specialists created a visual workplace with daily productivity numbers for the cutters as well as graphs indicating the number of blocks received, in arrears, and cut for the week. Unscheduled absences, as well as the revocation of overtime, were addressed with personnel in an attempt to change the culture of non-attachment to job responsibilities. Pathology residents' quality improvement studies identified areas of over-blocking for placentas, fibroids, and submission of specimens deemed unnecessary for pathologic review. Within the five month period the entire backlog was erased and a 24 hour TAT maintained. Productivity of technologists increased to 80 - 165 slides per day.
Conclusions: We showed that the application of Lean methods resulted in increased productivity. The involvement of front line staff in work redesign created a culture of process ownership. The performance of quality improvement studies and root cause analysis resulted in increased efficiency.
Category: Quality Assurance
Monday, March 19, 2012 1:00 PM
Poster Session II # 242, Monday Afternoon