Case Study 1
NHS Pathology Lab Layout

Scope:
A pathology lab, recognising their need to improve efficiency turned to the Lean approach to build stability in current operations. LMR was requested to review current automation proposals which would significantly change the layout and potential throughput. LMR, using a Value Stream Map, was able to propose the necessary changes with qualified improvements. The scope of the work was to cover both urgent and non-urgent blood samples from 2 locations within the Hospital. These were to include Accident and Emergency and one Ward.

Application:
LMR’s approach was to create a cross functional team including Lab staff, a Ward Sister, an A&E Sister, Phlebotomists and Trust Porters to understand their problems, their role in the operation and the restrictions placed upon them by other departments and systems. LMR, having gained an insight into operations decided the best approach to address the client’s current position would be to make a high level Value Stream Map, a detailed level process flow diagram and at the same time analyse the concerns through a concern resolution process.

Visual Workplace ( Information Centre)
The client was also able to identify/quantify a mismatch in the profile of samples received by time and current working hours. This is now being used by the client to investigate manually controlling that profile to fall in line with working hours.

Problem Resolution
A3 sheets designed to capture problems, allocate responsibility and effectively drive countermeasures were introduced into each department of the Lab. Clarity of roles in problem solving has led to better teamwork among the staff and a clearance of recurring problems affecting flow.

Process layout and Flow
A new layout was designed and proposed to improve the flow of the samples and create standardised processes.

Quality
The introduction of a new labelling process reduced the inconsistency in the blood sampling process with a reduction in the number of re-sampling required of patients.

Results:
Process layout and flow changes would reduce the total throughput time for samples from an average of 69 minutes to 32 minutes. £1m cost avoidance in capital expenditure. TPM and Quality would contribute to a reduction of handwritten forms by 75%. This would be supported by an introduction of standardised work and systematic training throughout the hospital. ROI on LMR resource 100:1.