Hassell Lewis A, Glass Crystal F, Yip Clinton, Eneff Patricia A
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
OU Medical Center, Oklahoma City, Oklahoma, USA.
BMC Clin Pathol. 2010 Feb 8;10:2. doi: 10.1186/1472-6890-10-2.
Histologic samples all funnel through the H&E microtomy staining area. Here manual processes intersect with semi-automated processes creating a bottleneck. We compare alternate work processes in anatomic pathology primarily in the H&E staining work cell.
We established a baseline measure of H&E process impact on personnel, information management and sample flow from historical workload and production data and direct observation. We compared this to performance after implementing initial Lean process modifications, including workstation reorganization, equipment relocation and workflow levelling, and the Ventana Symphony stainer to assess the impact on productivity in the H&E staining work cell.
Average time from gross station to assembled case decreased by 2.9 hours (12%). Total process turnaround time (TAT) exclusive of processor schedule changes decreased 48 minutes/case (4%). Mean quarterly productivity increased 8.5% with the new methods. Process redesign reduced the number of manual steps from 219 to 182, a 17% reduction. Specimen travel distance was reduced from 773 ft/case to 395 ft/case (49%) overall, and from 92 to 53 ft/case in the H&E cell (42% improvement).
Implementation of Lean methods in the H&E work cell of histology can result in improved productivity, improved through-put and case availability parameters including TAT.
组织学样本都要经过苏木精-伊红(H&E)切片染色区域。在这里,手工操作与半自动操作相互交织,形成了一个瓶颈。我们主要在H&E染色工作单元中比较解剖病理学中的替代工作流程。
我们根据历史工作量、生产数据以及直接观察,建立了H&E流程对人员、信息管理和样本流动影响的基线测量。我们将此与实施初步的精益流程改进后的绩效进行比较,这些改进包括工作站重组、设备重新安置和工作流程均衡,以及使用Ventana Symphony染色机来评估对H&E染色工作单元生产力的影响。
从大体标本处理站到病例组装完成的平均时间减少了2.9小时(12%)。不包括处理人员日程安排变化的总流程周转时间(TAT)每例减少了48分钟(4%)。采用新方法后,季度平均生产力提高了8.5%。流程重新设计将手工步骤数量从219个减少到182个,减少了17%。标本的移动距离总体上从每例773英尺减少到395英尺(49%),在H&E工作单元中从每例92英尺减少到53英尺(提高了42%)。
在组织学的H&E工作单元中实施精益方法可提高生产力,改善包括TAT在内的吞吐量和病例可得性参数。