At the Far Eastern Memorial Hospital in Taiwan, we trained our 17 hospital laboratory staff in Lean Six Sigma (LSS), a system for improving efficiencies and reducing waste. In doing so, we achieved a major performance boost in our outpatient, inpatient and emergency room labs.

An important part of LSS implementation is the selection and measurement of KPIs. One initial area of focus was staff over-utilisation. Our analysis of the data showed that staff were over-utilised by 14 of 24 total hours (1). This indicated that there was significant room for improvement in our lab operations.

The result: Better patient experience and faster turnaround times

One of the most successful changes brought about by implementing LSS was in blood collection services. Between January 2016 and October 2016, the average waiting time was reduced by 11 minutes to only 9.96 minutes. This led to more positive and regular feedback from customer surveys. We had no feedback from 2013 to 2015 but received regular feedback each month from April to October 2016, providing even more data to help us manage our operations.

We also simplified and streamlined our other lab operations. In the outpatient lab, for example, we initially counted 146 total steps in the workflow process with 34 decision points, but after applying LSS, we found opportunity to reduce this to 98 process steps and only 5 decision points. For the inpatient lab, we found opportunity to move from 79 to 31 process steps and from 20 decision points down to only 2, and completely eliminated all transport steps.

By reducing process steps and decision points, we made substantial improvements in turnaround time (TAT) achievement rates. Outpatient TAT achievement rate went from 80.7% to 90.5%; inpatient TAT achievement rate went from 78.9% to 86.3%; and ER TAT achievement rate went from 76% to 92%.

1: Sample Handling Time = No. of samples x (sample reception time + sample processing time) per sample for top 5 test groups
Based on 21.12.2011 (Wed) LIS data
Test groups N, H, C, U and I (n = 2,268)
Over staff utilisation = total sample handling time > staff allocation

This article is based on the presentation “System Optimization in Medical Laboratory” at Roche Efficiency Days (RED) 2017, Taipei, Taiwan.