Improving preanalytic processes using the principles of lean production (Toyota Production System)

Area of Science:

• Clinical Chemistry
• Laboratory Medicine
• Healthcare Operations

Background:

• Preanalytic processes for clinical chemistry tests have historically seen slower advancements compared to analytic and postanalytic stages.
• Optimizing preanalytic workflows is crucial for improving overall laboratory efficiency and patient care.

Purpose of the Study:

• To enhance chemistry test turnaround time in a central laboratory setting.
• To implement lean production principles for optimizing preanalytic workflows.
• To achieve a target of reporting 80% of chemistry tests within one hour.

Main Methods:

• Application of lean production principles (Toyota Production System) to redesign preanalytic workflows.
• Streamlining processes by reducing steps and implementing one-piece flow for sample handling.
• Focusing on accessioning, centrifugation, and aliquoting stages.

Main Results:

• Median preanalytic processing time decreased from 29 minutes to 19 minutes.
• The laboratory successfully achieved the goal of reporting 80% of chemistry results in under one hour.
• This performance benchmark was sustained for 11 consecutive months.

Conclusions:

• Redesigning preanalytic processes using lean methodologies can significantly reduce clinical chemistry test turnaround times.
• The implementation demonstrated the feasibility of achieving rapid result reporting without compromising quality.
• Eliminating the distinction between routine and expedited testing enhances laboratory efficiency and patient management.