Lean thinking - pathology

Our team were engaged by a Pathology laboratory service provider to assist with the deployment of lean thinking methodologies to streamline the flow of Patient specimens.

This Pathology laboratory provides comprehensive biomedical laboratory services including anatomical pathology, Blood bank, Clinical chemistry, microbiology, endocrinology, Haematology and Molecular cytogenetics to some of the state’s largest tertiary and referral specialist facilities including Prince of Wales, St George, Wollongong and the Royal Hospital for Women.

Within any healthcare facility the primary objectives relate to Patient care, and as such the speedy and timely manner in which results can be fed back to the Doctors play a vital part in diagnosis and treatment of patients. Our brief was to review and implement change through the Central specimen reception areas of the Laboratory in order to ensure Specimen reception could rapidly process and deliver accurate information and samples to the subsequent departments.


reduction in the turnaround time for full blood count specimen (30.5 to
15.25 mins)


reduction in the turnaround time for chemistry specimen (34 to 25 mins)


reduction in the fluctuation of turnaround time throughout the day

Lean thinking - pathology


- Reductions achieved with 0.5 less FTE compared to pre-Lean times
- Walking distances reduced by 15%

Lean thinking - pathology


- Batching of samples causing significant delays in the processing time
- Poor process flow resulting on backwards and forwards movement of the specimen
-Layout and space concerns leading to excessive walking
- Forms waiting to be scanned resulting in specimen not being able to be processed even if they had reached the next department
- Errors due to patient details being entered incorrectly
- Double handling of specimen through the process
- Large fluctuations in workload throughout the day
- Poor staff scheduling
- No visibility of ahead or behind within the process

Lean thinking - pathology


- Reduction in turnaround time for processing of samples
- Minimisation of processing steps and a reduction in complication of process by improved layout
- Reduction in amount of rework
- High level of staff engagement to promote ownership of the process
- Development of a pilot ‘Lean’ site as a model for other central specimen reception’s across the organisation

Lean thinking - pathology


- Undertake a blue sky activity with all stakeholders and staff to understand their frustrations and concerns
- Carry out waste walks to uncover areas of waste in the process
- Map out the current process, identify areas of improvement and create a future state vision for the department
- Create individual working groups to tackle the issues identified such as Layout improvements, one piece flow introduction and standardised work
- Implement flow racking into the process to enable staff to run first in first out
- Introduce standardised work documents, key performance indicator boards, 5S and problem and countermeasure processes