A Lean Approach Improves a Medical Laboratory

The latest news about lean principles being applied to healthcare comes, appropriately, from the Henry Ford Health System in Detroit.

            In an article being published in the September 2007 issue of the American Journal of Clinical Pathology, researchers describe how they used what they describe as “deep and honest self-analysis and the concerted effort of all workers” to improve operations of the laboratory, which is the 15th largest lab in the U.S. The institution processes more than 6.5 million specimens annually.

            A news release describing the article reports:

         The new system has resulted in more than 100 improvements, each making a small but effective enhancement to the quality and timeliness of care. For instance, they have implemented the use of bar code-specified work processes to reduce specimen identification and work product defects, and results for routine biopsies have improved from 73 percent being completed in one day to 92 percent being completed in one day.

'The Henry Ford Production System is not just about waste reduction but adopts the best of the Toyota Production System's approach to people,' said co-lead researcher Richard J. Zarbo, MD, DMD. 'To be successful in using manufacturing-based approaches to quality requires nothing less than a complete cultural shift in the American workplace that gives every worker and manager a way to design their work in a blame-free and cooperative environment thereby unleashing their profound creative potential.'

            I don’t usually hear people talk about the “Henry Ford Production System,” but we’ll let that one pass.

            How did the staff achieve the improvements?

         Zarbo and co-author Rita D'Angelo, MS, ASQ CQE, SSBB found most helpful the use of a mounted visual data display poster to enter defects, rate their importance and their root causes. Six Sigma performance metrics were then utilized to make choices to improve quality.

The team redesigned specimen sorting to eliminate redundant steps, standardized tissue size to eliminate cassette opening during processing, and implemented action alerts to flag cases for critical values.

            Sounds like classic applications of lean approaches.

            What is particularly encouraging about this report is that it is being published in a clinical journal, which is read not by manufacturing people who have already heard about lean ad infinitum, but by healthcare professionals who are only beginning to hear about it.

            Good news.



Ralph Bernstein said...

9/10/2007 12:43:24 PM
Re: A Lean Approach Improves a Medical Laboratory
by: mgraban

It's ironic that Toyota learned from Ford (the company) and now Ford (the hospital) is learning from Toyota. "Henry Ford Production System" refers to the hospital, not the company, right? Still sounds odd, I agree.

Ralph Bernstein said...

9/10/2007 12:44:34 PM
Re: A Lean Approach Improves a Medical Laboratory
By: dcbliss

We viewed the work that Henry Ford is doing, and it's great, classic Lean work. There are many medical labs across the country adopting Lean methods to significantly decrease the turnaround time for tests. By the way, the "Henry Ford Production System" is their term for the adpotion of TPS - not unlike the "Virginia Mason Production System" term used by the Virginia Mason Medical Center in Seattle. We chose not to use the term "production" in our hospital (to distinguish healthcare from manufacturing), but if it works for them, that's great.