The Evidence-base Study About Apply Lean Methodology to Improve the Processes of Hospital Laboratory

• Main Authors: Ya-Wen Cheng, 鄭雅文
• Other Authors: Ching-Hsiang Chang
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/97616664713139880204

碩士 === 長榮大學 === 醫務管理學系碩士班 === 101 === Background and Motivation：Since National Health Insurance was implemented in Taiwan implementing, now hospitals in Taiwan have been faced with the problems of the highly increasing costs and manpower shortage. Also, the medical staffs participated in many accreditations caused overworked situations, so that the phenomenon of “Sweat Hospitals” appeared and has existed in Taiwan. Based on the intention to improve this current issue, this study is going to investigate the Lean System applied by these foreign medical institution with successful outcomes. Method: This case study worked on Lean methodology with the purpose to improve the stat and routine processes of hematology, urinalysis and chemistry. There are a list of five principles involved in this study: Evaluation, Define Value Stream, Flow Model, Pull Model and Perfection to experiment the laboratory process how to decrease the seven wastes. With the application of Lean system, it found out the wastes of transported specimens, staff walking and waiting in laboratory processes. Automation and auto-verification system are used in the processes of hematology, urinalysis and chemistry to solve the unnecessary wastes in laboratory processes. And the routine specimen transportation are changed from Batch Flow to One Piece Flow. Results: The case in the hospital’s laboratory has concrete results after the application of Lean System. First of all, The laboratory layout freed up 63.4 m2 of space . Secondly, specimen traveled distances for chemistry tests was reduced to 13.3 meters. Thirdly, to analyze the improvement in the processes of Turnaround Time (TAT). According to comparative analysis we found, the average TAT of Stat and Routine, each dropped down to 27% and 66.4%, after improving the hematology procedure； 31%, 58.9% in urinalysis, and 11.4%, 36.4% in chemistry. Conclusion: The hospital laboratory with the application of Lean Methodology can efficiently decrease wastes and improve processes of hematology, urinalysis and chemistry. Besides, the routine specimen transportation was changed from Batch Flow model to One Piece Flow model and obviously decreased wastes. This study has applied this learn methodology to improve the processes of hospital laboratory, reduced staff workload and promoted service efficiency. Accodingly, the hospitals can offer the high quality medical service for their patients.