CEO SUMMARY: Before a redesign of phlebotomy workflow at Marshfield Clinic, patients might wait as long as an hour, particularly before noon when phlebotomists would see 75% of each day’s patients. After the redesign, the number of draw sites was reduced from five to two while handling an increase in daily patient volume from 700 to 855. Patient wait times fell
Lean Six SigmaSkip to articles
Lean Six Sigma is a management technique consisting of both Lean and Six Sigma techniques. This produces a methodology that relies on a collaborative team effort to improve performance by systematically removing waste (Lean) as well as defects, overproduction, waiting, non-utilized talent, transportation, inventory, motion and extra-processing (Six Sigma).
Lean production, often simply “Lean,” is a systematic method for the elimination of waste within a manufacturing process. Lean also takes into account waste created through overburden and waste created through unevenness in workloads. Working from the perspective of the client who consumes a product or service, “value” is any action or process that a customer would be willing to pay for.
Essentially, Lean is centered on making obvious what adds value by reducing everything else. Lean manufacturing is a management philosophy derived mostly from the Toyota Production System (TPS) and identified as “lean” only in the 1990s.
Six Sigma, like Lean, is used to improve the quality and efficiency of operational processes. During the past decade, these process improvement techniques increasingly have been applied outside of the manufacturing sector, for example, in healthcare.
While Lean focuses on identifying ways to streamline processes and reduce waste, Six Sigma aims predominantly to make processes, such as those used in clinical laboratories and pathology group labs, more uniform and precise through the application of statistical methods.
The principles were originally developed by Bill Smith of Motorola in 1986 as a way of eliminating defects in manufacturing, where a defect is understood to be a product or process that fails to meet customers’ expectations and requirements. The name refers to a quality level defined as the near-perfect defect rate of 3.4 defects per million opportunities. As a process improvement strategy, it gained much attention through its association with General Electric and its former CEO Jack Welsh.
This combined process improvement has become popular with clinical laboratories as a way to streamline laboratory processes and cut costs in a time when labs are increasingly pressured by downward price trends for lab tests. At the same time, labs are able to increase value offered to “customers,” that is, patients.
The Lean Six Sigma concepts were first published in a book titled Lean Six Sigma: Combining Six Sigma with Lean Speed by Michael George and Robert Lawrence Jr. in 2002. Training is provided through the belt based training system similar to that of Six Sigma. The belt personnel are designated as white belts, yellow belts, green belts, black belts and master black belts, similar to karate.
CEO SUMMARY: As healthcare transitions away from fee-for-service payment and adopts new models of reimbursement, every clinical lab will need to deliver more value with its lab testing services. At Henry Ford Health System in Detroit, the laboratory division has blazed a path of improving lab performance specifically to enable it to add value to
CEO SUMMARY: Henry Ford Health System’s laboratory organization has become first in the nation to have all its laboratory sites “standardized under one source of leadership” and accredited to the standards of ISO 15189: Medical Laboratories. The journey to achieve this current state has taken almost 10 years and started with the development of a
CEO Summary: Pathologists at Ottawa Hospital not only must handle a large volume of specimens regularly, but are experiencing a 14% per year growth in the number of specimens. Last year, when the average turnaround time for a case was nine days, the pathology department embarked on a series of Lean and process improvement projects.
CEO SUMMARY: There is good news for those clinical labs and pathology groups currently operating robust Lean, Six Sigma, and process improvement programs. The Institute of Medicine’s new report calls for all healthcare providers to rapidly transform themselves into ‘continuously learning’ organizations. These developments met with a welcome reception at the recent Lab Quality Confab,
CEO SUMMARY: One new byword coming to healthcare in the United States is the “continuously-learning healthcare system.” At the upcoming Lab Quality Confab in San Antonio next month, lab managers and pathologists can learn more about how to achieve and sustain continuous improvement in their laboratory organization. Pathologists and lab managers who have been active
CEO SUMMARY: Seeking to improve turnaround time for stat lab tests, the laboratory at Sarasota Memorial Health Care System identified high rates of hemolysis as the chief reason for less than ideal TAT. Because 32% of blood draws were handled by the lab’s phlebotomy staff while 68% of blood draws were performed by nurses and
CEO SUMMARY: In Brampton and Etobicoke, Ontario, the hospital laboratories of William Osler Health System are using the quality management system of ISO 15189 to stay ahead of two powerful trends. Combining the QMS with Lean methods allows the labs’ management and staff to continuously improve performance in four important dimensions: decreasing turnaround times, reducing
THIS MONTH, THE NATION’S NEWEST “designed from scratch” clinical laboratory facility began operating in Minneapolis, Minnesota. It is the central laboratory of Allina Hospitals & Clinics and its design is rooted in Lean and similar process improvement and workflow principles.
The $29 million new facility consolidates laboratories from 12 locations in five different Allina buildings into
CEO SUMMARY: Lengthy wait times for patients at phlebotomy sites is a common problem for labs across the country. But the laboratory at WellSpan Health System in York, Pennsylvania decided to apply Lean methods to change this situation. Their Lean projects at two pilot patient service centers (PSC) produced a reduction in average waiting times