Lean thinking in hospital: Case study at the pathology laboratory

Abstract

When a good is produced a lot of transformations have to be made in order to satisfy client request. All of the phases are made in specific work-cells: the material is moved between the cells with an high risk of errors or lost of efficiency. Error free management is frequently used when the failure of the process is involved with a significant lost of production. A lot of tools (e.g. FMEA, FTA) are developed to increase reliability and efficiency too: lean thinking is one of these. Lean thinking is a specific method born in automotive but all the principles are applicable to hospital. The methodology uses “7 wastes analysis”, “Spaghetti Map” and “Value Stream Map” which are useful tools uses to describe the entire process by consumer point of view. “7 Wastes analysis” is used to divide value operations from non-value operations. “Spaghetti Map” is a specific diagram where it is easy to see useless movements. Lastly, “Value Stream Map” is the description of the process from the request to the delivery individuating the specific point of value. Takt Time and Cycle Time are calculated in order to define where the improvements have to be focused. In reference to histology a lot of improvement can be made: particularly, Takt Time showed unbalanced workload between the work-cells and cycle time revealed non-value added operations, some eliminated by software improvement. Goal of this paper is to show an application method of Lean Thinking for a complex healthcare process, which it is pathology laboratory.