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  • Title: Improvement of laboratory turnaround time using lean methodology.
    Author: Gupta S, Kapil S, Sharma M.
    Journal: Int J Health Care Qual Assur; 2018 May 14; 31(4):295-308. PubMed ID: 29790443.
    Abstract:
    Purpose The purpose of this paper is to discuss the implementation of lean methodology to reduce the turnaround time (TAT) of a clinical laboratory in a super speciality hospital. Delays in report delivery lead to delayed diagnosis increased waiting time and decreased customer satisfaction. The reduction in TAT will lead to increased patient satisfaction, quality of care, employee satisfaction and ultimately the hospital's revenue. Design/methodology/approach The generic causes resulting in increasing TAT of clinical laboratories were identified using lean tools and techniques such as value stream mapping (VSM), Gemba, Pareto Analysis and Root Cause Analysis. VSM was used as a tool to analyze the current state of the process and further VSM was used to design the future state with suggestions for process improvements. Findings This study identified 12 major non-value added factors for the hematology laboratory and 5 major non-value added factors for the biochemistry lab which were acting as bottlenecks resulting in limiting throughput. A four-month research study by the authors together with hospital quality department and laboratory staff members led to reduction of the average TAT from 180 to 95minutes in the hematology lab and from 268 to 208 minutes in the biochemistry lab. Practical implications Very few improvement initiatives in Indian healthcare are based on industrial engineering tools and techniques, which might be due to a lack of interaction between healthcare and engineering. The study provides a positive outcome in terms of improving the efficiency of services in hospitals and identifies a scope for lean in the Indian healthcare sector. Social implications Applying lean in the Indian healthcare sector gives its own potential solution to the problem caused, due to a wide gap between lean accessibility and lean implementation. Lean helped in changing the mindset of an organization toward providing the highest quality of services with faster delivery at an optimal cost. Originality/value This paper is an effort to reduce the gap between healthcare and industrial engineering and enhancing the use of lean practices in Indian healthcare. The study is motivated toward implementing lean methodology successfully in services.
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