Abstract
PurposeHealthcare environments are highly complex and full of variation and inefficiency. However, variation and inefficiency can be measured and improved, providing better quality care at a lower cost. This study aims to report the application of Lean Six Sigma (LSS) in a haematology laboratory in a university hospital in Egypt.Design/methodology/approachThe authors used case study research. Applying the define, measure, analyse, improve and control phases of the DMAIC methodology together with lean tools, the problem was identified, the process mapped, the causes analysed and improvements implemented.FindingsResults show that LSS can be successfully implemented in challenging public sector healthcare settings. Management commitment, generating and implementing ideas from frontline staff, using a variety of quality tools and previous LSS training were all key to success. This is evidence that the LSS methodology is adaptable to any process, people or place.Originality/valueThere are no publications on LSS implementation in health care in Egypt. This study demonstrates the successful use of LSS in a university hospital (public sector) in a developing country, sharing insight into the facilitators and barriers in a real context with others in the healthcare field.
Highlights
Laboratories play a vital role in clinical decision-making in terms of diagnosis, prognosis and treatment
This study demonstrates the successful use of Lean Six Sigma (LSS) in a university hospital in a developing country, sharing insight into the facilitators and barriers in a real context with others in the healthcare field
We describe the application of LSS to improve the timeliness of routine Complete Blood Count (CBC) test results in the haematology laboratory in a university hospital in Egypt
Summary
Laboratories play a vital role in clinical decision-making in terms of diagnosis, prognosis and treatment. A large US study on 72,196 patient encounters, found that 38% had laboratory tests ordered, compared to only 22% for radiology. This figure was higher for inpatients (98%) than for emergency department (56%) or outpatient encounters (29%) (Ngo et al, 2017). Clinical laboratories have traditionally focused on internal indicators of analytical quality, whereas their main customers, physicians, are more keen on service quality; of which, timeliness is the key “satisfaction factor” (Kappelmayer and Toth, 2016; Tsai et al, 2019). Shorter TAT increases patient benefit through earlier clinical decisions and reduced Length of Stay (LOS), improving physician and patient satisfaction, and saving cost (Kaushik et al, 2018; Tsai et al, 2019)
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