Implementation of Lean Thinking in the Diagnostic Laboratory - Report Example

Implementation of Lean thinking in the diagnostic laboratory  Prepared on  By:  For:                    Abstract       The purpose of this paper is to study the effects of lean thinking in diagnostic laboratories. Lean thinking is an aspect which involves transformation in the way these laboratories function and how they provide services to patients. Transformation of an organization through lean thinking can have a lot of impact on the quality of services and the cost. The main aim of this aspect is to produce quality services to patients at a low cost. Different sectors and settings have different approaches of lean thinking for instance the lean thinking in the manufacturing industry is different from that used in diagnostic laboratories. There are principles that govern the provision of services at relatively low costs. Determination of valuable and non value factors is one of the most important steps in carrying out lean thinking. The non value factors should be disregarded as they cause delays and poor quality services. Good implementation of lean thinking would ensure quality services at subsidized costs (Wisconsin Medical Alumni Association 1972). Introduction       There are many changes that have been taking place all along since the beginning of the nineteenth century. These changes demanded for the transformation of industries and other sectors to be able to cope with these changes. Lean thinking is one process that was first postulated by James Womack and Daniel Jones to help executives and managers a through the transformation. This process is governed by several principles which if followed appropriately would lead to turn around in most organizations and sectors (Mortensen). Lean thinking is also gaining momentum in many sectors and is being embraced in sectors like the health care. Good management and transformation in this sector is changing not only the management but also in other areas that are involved in managing human resources for better services. Statement       Lean thinking is one process that has improved results. This process was derived from the manufacturing industries when the manufacturing industries shifted from craft manufacturing to massive manufacturing and finally to the lean manufacturing. In the health care sector, this has been important in transforming the provision of services to the general public. The laboratory environment is very different from the manufacturing environment and therefore there are different approaches and techniques of lean thinking that will be utilized (Decker and Stead, 2008).  The coat of health care in general is rising at a very high rate and there is need to reconsider these costs by reducing the cost of services both internally and externally, reduce errors, increase profits, decreasing dependence on other sources of funds and providing quality and long lasting services (Journal of clinical and diagnostic research, 2001).       Lean is a strategic business plan or a state of the mind that is utilized in curbing competition. However, provision of these services does not always involve competition but it also includes providing quality services at subsidized costs. This is the major reason for the use of lean thinking in health care especially in the laboratories. Lean is easy but few people and organizations have been seen utilizing this model in their quest to improve services and provide them at low costs. This term is usually seen as simple but in the real sense it is difficult to implement to achieve the aforementioned goals. The main objective or mission of lean is to provide quality services by adding value to the steps or processes involved (Kaplan, 2008).       The solution to a successive lean is waste devoid and timely determination of problems or limitations (Womack and Jones, 2003). By so doing, the laboratory managers can be able to find interventions or solutions to these problems and solutions before it is too late. Lean does not depend on opinions or speculations but depends on the available data and facts. Different levels of thinking while a problem arises would greatly help the application of lean in not only the laboratories but also in other organizations. Continuous improvement of solutions adopted is very encouraging as the patients will always be sure that they will obtain quality services on time. Sharing of ideas by brainstorming the possible solutions to certain problems in the laboratory would help the workers in working tirelessly and ensuring that quality services are delivered without any delays. Meeting or exceeding the patients' expectations can boost the trust by patients who are major customers to the laboratories (Auxter, 2003).       There are several principles that have to be followed while working in a laboratory. It is important to reduce or eradicate variations in the laboratory field. This can be done by practicing the methods that help workers to do so. The laboratory working area should be cleaned and well organized. All materials, reagents and other important materials should be safely kept and well labeled for easy accessibility. Each processes has its own tools for their functionality, lean thinking and utilization is not an exception also and these tools have to taken care of and be improved for continuously quality. All projects should have a definite time by which they should be finished. This can be enhanced by reduction in wastage and improvement of the services provided (Kaplan, 2008).       Many hospitals and laboratories are associated with poor services provision. Despite a lot of investment by these sectors in a bid to provide better services, this is not realized. There are several reasons why this has proved futile. The major reason is that these sectors lack the willingness to change timely. It is unfortunate that patients have to wait for a long time before they can get practitioners to serve them. Laboratories are also included in this as there are times when the results are not available on time because of reasons that could have been avoided. These factors demand for transformation of these sectors so that services are provided timely and at relatively low costs. Lean thinking and management was the best way in which these sectors could be changed (Bell, 2005).       Lean thinking would be very effective in eliminating waste of time and reducing costs as it appreciates the value of the patient. In fact according to some demographic studies, 30- 60% of costs are wasted and as much as 80% of time might end getting wasted in some areas. There was need for transformation of this critical sector in such a way that services would be provided at the right time without any wastage. This should be taken more serious in the laboratory settings as the results or samples can be a matter of survival or death depending on whether the services were provided timely or not (Auxter, 2003).       In his view, Slater strongly believes that lean thinking has a lot of effect in the future of services provided in the laboratories. He used a classic example basing on specimen collection where specimens were checked against a request form and then checked later during processing. He argued that there was wastage in checking the sample twice and a single check would be enough. He proposed that one of the checking be removed and the time available would be used in other tasks. Lean thinking could also be used in determining the non value steps or areas which could be redesigned to be more valuable and at the same time reducing delays and ensuring quality (Kaplan, 2008).       There are several factors that have to be considered for the achievement   of lean thinking in the laboratories. The first and one of the most important factors that has to be considered is the structured problem solving ability. Team at the laboratory should be aware of the problems encountered and the approaches that can be undertaken to solve them. Data on the problem should be corrected to be able to measure the extent of the problem and understand it well. The cause of the problem is then determined and looked at carefully after which ways of solving the cause of the problem is devised. Once the problem is solved, the remainder is to ensure improvements are made and maintained accordingly (Auteur, 2003).       The services provided to customers or patients have value. All the valuable and non value factors and steps should be determined and the non valuable ones removed from the process of providing services or intervention measures be introduced. There are factors which are involved in wasting the patients' time thereby increasing the cost for the services to be obtained. Some of these factors include transport, invention, delays, over production, movement of people and delays. Inventions are important in reducing the distance covered in travelling or movement of goods in this case samples. If there is a lab without the capability to perform some tests, machines and equipments for that test can be put in place by careful arrangement. This can greatly reduce costs incurred while transporting samples to other places and at the same time save time (Kaplan, 2008).       People waiting for their laboratory results for long hours are not new phenomenon.  There before the lean methodologies became common, this was the trend and it was not caused by lack of workers moistly butt lack of good organization and also many non valuable processes were widely used. Also, there were imminent errors which needed correction for production of quality services at low costs. A good lean analysis should be able to identify the value being created, map the process and determine where wastes are and introduce strategies for reducing or removing them totally. The strategies introduced to solve these problems should be continuously improved to prevent such wastes in future (Liem, 2004).       Working in laboratories is very challenging and stimulation from time to time is very important. For good service provision, the laboratory management has to ask it self some key questions in order to meet the patients' demands. If there is overwhelming work, they should ask themselves a question like what if we added more equipment. What if we extended working hours? Or what non value factors can be eliminated? These questions can turn around the working of the laboratory by meeting the demands and at the same time providing quality services. Implementation of this can be very challenging and costly. However, the benefits of such investments are not instant and therefore the laboratory should not provide them expecting immediate returns (Association of America’s Medical colleges, 2008).       The major objective of the lean thinking is work to flow through value adding steps without any delays. Fragmentation of services in sectors apart from each other should be discouraged at all costs as it is capable of causing delays during transportation of samples. Transportation as aforementioned is one of the wastes and causes delays in the delivery of services to patients. Improvement of these laboratories would be important in reducing costs and time. Whenever a duty is divided between two groups, time wasting is inevitable as work is done in batches and taken to the other party for finishing. Lean layouts should be used in such cases as they bring processes closely related nearer thereby reducing delays (Decker, 2008).       Laboratory managers have a rough time in ensuring maximum production quickly. However, for this to be achieved, work flow control has to be done effectively and timely. In most fields including the laboratories, there are conflicts of interest between efficiency and effectiveness. These two factors have to be at a balance for quality services without time wastage. There are several work flow controls which include Constrained Work in Progress in which a laboratory aims at completing certain work within a given period. The laboratory has to work between 70 and 80% and this can be determined by stimulation in complicated environments (Borgert).       A laboratory can also increase the frequency of working other types of jobs and at the same time ensure no delays. This is shown by mixed scheduling and every product every which usually measures how the frequency of different types of jobs is scheduled. There is another way in which work in a laboratory can be controlled. Use of signaling system to indicate when there is work required is the other work controlling method. This system can also be used for replacement of relevant laboratory materials. Promising of work depending on the progress is also important in clearing out the work and not putting pending work in to a system (Lean Sigma Labs, 2008).       When progressing with work, it is vital to continue monitoring the work to ensure quality and reducing variation. Close monitoring allows detection of errors and timely intervention to bring the experiments under tight control. Monitoring also makes it easy for determination of sources of errors if any are detected. Early determination of errors and early intervention reeducates the chances of variation of the process thereby improving the quality. This factor may call for the formation or development of methods that are quality and are resistant to variation. Design of experiment is what deals with this critical aspect of development of methods (Journal of Clinical and Diagnostic Research).       In laboratories, good maintenance of machinery and other equipments is very critical as they can easily compromise the results of patients. Total maintenance program deals with maintenance of these equipments in good condition so that they can work within given specifications and produce quality work. It is important to understand the reliability of every equipment and also the possible consequences if by any chance they fail. If the equipment fails, it is the duty of the manger to know if there is any part required the urgency and how it can be fixed. Reliable results are expected and therefore the functionality of every gadget has to be determined and at what limits can it work on (Bell, 2005). The use of lean has brought about a paradigm shift noticeably improving performance in many laboratories all over the world. Laboratories are being designed in such a way that there is increased efficiency of the labs operations. Implementation of work cells is very important as it brings order and facilitates efficient work flow. Lean work cells together with other lean strategies increase productivity and greatly reducing time wastage or delays (Thomas, 2006). Proper utilization of these work cells brings about standardization of work procedures and transition to inventory management. Lean work cells have reduced delays, provided high quality services, minimized travelling and walking distances, improved accessibility of state of operations and reduced the amount of work in progress. Laboratory operations are usually grouped together or are done from the same area arranged in a U shape. Lean work cells are arranged in such a way that they make a sequence in which the processes on a certain product follow a sequence. Mostly, these labs are organized in such a way that all the processes are done in a single place or within a small area thereby doing away with transportation and may be walking for long distances. This reduces delays which are brought about by these factors when not done within a small area. There are some invaluable tools for diagnosis of some conditions in patients. One of the examples is automated urinalysis which involves urine testing and accounts for about a third of all laboratory specimens (Cronin, 2008). Lab technicians are working tirelessly so as to improve the efficiency of testing urine and saving time or avoiding unnecessary delays. This method is commonly used for screening urine tract infections. For a long time now, manual machineries were used until recently when some of the labs are doing away with the old manual machinery and embracing the new automated machineries. The use of automated machinery allows the laboratory technicians to easily detect pathogens like bacteria within a short time approximately two minutes (Tang and Stratton, 2006). These methods are advantageous in that they speed up testing thereby preventing unnecessary costs. The first automated machine was first introduced in 1995 and led a change from a time consuming and labor intensive urine analysis to a fast way of testing urine in approximately two minutes. Automated machines are by far accurate than the manual ones as there is less human intervention. Standardization of histopathology laboratories is critical as lack of it can lead to numerous errors, poor quality, inefficiency and increased costs. Effectiveness of large scale quality improvement and has been evaluated at rare instances. However, with lean interventional skills, there can be a turn around of events in these laboratories. Some demographic studies have shown that intervention led to increment in the productivity ratio. Lean intervention has shown transformation in the provision of services in most laboratories (Price and Christenson, 2008).       Conclusion       Lean thinking is one of the most important aspects of transformation in any given sector or organization (Shelly). However, for achievement of this, managers and their followers have to be involved actively. Lean is a relatively easy term that is hard to implement. With willingness and commitment, the goals of providing good services at low costs will definitely be achieved. It would be very encouraging if more sectors and organizations adapt this method.         References Decker, W. W and Stead, L. G. 2008. Application of lean thinking in health care: a role in emergency departments globally. 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