AI Article Synopsis

  • The study aimed to assess if Lean methodologies could enhance laboratory workflow and reduce turnaround times (TAT) for tests in an emergency department.
  • After reorganizing the sample flow without additional resources, there were significant decreases in TAT for several tests, particularly for reflex tests like troponin T and urine sedimentation.
  • The results suggest that applying Lean principles in healthcare can boost efficiency and may lead to overall improvements in quality and cost-effectiveness in healthcare delivery.

Article Abstract

Background: Increasing the value of health care delivery is a national priority, and providers face growing pressure to reduce cost while improving quality. Ample opportunity exists to increase efficiency and quality simultaneously through the application of systems engineering science.

Objective: We examined the hypothesis that Lean-based reorganization of laboratory process flow would improve laboratory turnaround times (TAT) and reduce waste in the system.

Methods: This study was a prospective, before-after analysis of laboratory process improvement in a teaching hospital emergency department (ED). The intervention included a reorganization of laboratory sample flow based in systems engineering science and Lean methodologies, with no additional resources. The primary outcome was the median TAT from sample collection to result for 6 tests previously performed in an ED kiosk.

Results: After the intervention, median laboratory TAT decreased across most tests. The greatest decreases were found in "reflex tests" performed after an initial screening test: troponin T TAT was reduced by 33 minutes (86 to 53 minutes; 99% confidence interval, 30-35 minutes) and urine sedimentation TAT by 88 minutes (117 to 29 minutes; 99% confidence interval, 87-90 minutes). In addition, troponin I TAT was reduced by 12 minutes, urinalysis by 9 minutes, and urine human chorionic gonadotropin by 10 minutes. Microbiology rapid testing TAT, a "control," did not change.

Conclusions: In this study, Lean-based reorganization of laboratory process flow significantly increased process efficiency. Broader application of systems engineering science might further improve health care quality and capacity while reducing waste and cost.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4628563PMC
http://dx.doi.org/10.1016/j.ajem.2015.06.013DOI Listing

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