Lean Six Sigma: optimisation and new technology in the enteric laboratory

A high-quality pathology service that encompasses accuracy and time-to-result is critical to most medical decisions. Errors in the laboratory have potentially serious consequences to the care of the patient and to the health economy as a whole. Automation and advanced technologies continue to provide innovative solutions; however, the overriding problem is to provide these with reduced budgets. The actual cost of improving processes often can be offset by designing quality into the process pathway.

The Lean Six Sigma approach, along with an innovative technological solution, BD MAX, has helped to identify inefficiencies, uncover opportunities to free capacity, reduce turnaround substantially, improve sensitivity, and enhance mistake-proofing of the process. This article analyses the traditional routine enteric process and interpretative pathways, implements improvements, and gives a review of results obtained by deployment of Lean Six Sigma and advanced technology. The traditional Define, Measure, Analyse, Improve, Control (DMAIC) methodology, along with Lean tools, was utilised. A number of deliverables were achieved through the project, most notably a reduced turnaround time (TAT) from a mean of 4216 hours to 269 hours, increased detection rates, reduction in non-value-added steps, an improvement in defects per million opportunities (DPMO) from 211,782 to 142, and also cost reductions.

Error rates
Serious and widespread problems exist in the quality of pathology services; too many patients are exposed to the risks of unnecessary errors and inefficient processes. In 2000, the Institute of Medicine published the report To Err is Human,1 which estimated 44,000 to 98,000 hospital deaths per year. An estimated 70% of medical decisions are influenced by clinical laboratory test results,2 and an estimated 700 million pathology tests are performed annually in the UK.3 Therefore, defects in the laboratory have potentially serious consequences to the care of patients and the health economy as a whole.