Lean Methodology for Pathology Laboratories: A Case Study from a Public Hospital

Abstract

Objective: The increase in the financial imposition of laboratories together with developing technology and evidence-based medicine applicationsincreased the importance of quality and efficiency studies in laboratories. The aim of the study is to examine the processes of pathology laboratory,determine the causes of waste and select lean management techniques to eliminate the causes of waste.Material and Method: A five-phase plan was used for the application of lean management in the pathology laboratory. After a comprehensiveliterature review, these phases were determined as follows; the support of the senior management, observation, training of employees, drawingof value stream maps and creation of value stream plan. Gastric biopsy process was selected as product/service family when value stream mapswere generated. In addition, fishbone diagram and Pareto analysis were used to determine the causes of waste.Results: In the current state, 73.6% of the time spent on a gastric biopsy sample in the pathology laboratory was wasted. The most commoncauses of waste were identified as problems with cleaning, equipment supply problems, lack of clinical information, equipment malfunctionand errors. A value stream plan was developed with lean techniques to eliminate the causes of these wastes. In the pathology laboratory, a 4.6%improvement will be achieved with the achievement of the future stated target.Conclusion: A model for lean management techniques in a developing country that will enable the pathology laboratories to work more efficientlyand with improved quality has been developed in this study.