Where in the World Is . . . My Cytology Specimen? Using Lean Six Sigma Methodology in Specimen Management

Abstract

Abstract Introduction An automatic signal was not in place to actively identify when a cytology specimen resulted more than 28 days from collection. The project focus was to decrease the number of specimens resulted more than 28 days and improve result cycle time to enhance safe, quality care delivery. Methods Annually, more than 46% of the cytology specimens processed at our academic medical center originate from our Women’s Health practice site. A Lean Six Sigma Green Belt project commenced with key stakeholders from the practice site, Cytology and Clinical Laboratory Departments. The project goal was to reduce the percentage of specimen results taking longer than 28 days from the baseline of 6.7% to ≤1.7%. Voice of the customer showed 75% of patients would be satisfied with results available within 7 days. Baseline data showed 38.6% of specimens resulted within 7 days with an improvement goal of 85%. Lean Six Sigma methodology was employed to develop standard work. The Cytology Department implemented use of work lists in the CoPathPlus system to track specimens from accession to results. Reconciliation of cytology specimens received versus ordered was performed weekly. Conclusions Baseline data were compared to postprocess implementation data. Hypothesis testing compared baseline to postimplementation cycle time means showing a reduction from 11.28 to 5.15 days (P < .001). Project goal of ≤1.7% for results greater than 28 days was exceeded at 0.22%. Cycle time goal of 85% for results within 7 days was exceeded at 91.6%. Signal presence to identify results greater than 28 days was reduced with improved cycle time for results reporting. With standard work implementation, 616 annualized labor hours and an annualized labor cost reduction of more than $19,000 resulted. The standard work developed has the capability to translate across all practice locations where cytology specimens are obtained.