Reports
Lean Laboratories: Competing with Methods From Toyota
Mark Graban, BSIE, MSME, MBA, CPIM, Shana Padgett, BS, MT(ASCP) (ValuMetrix Services, Ortho Clinical Diagnostics, Raritan, NJ)
DOI: 10.1309/LMX0LEMR7R0USKUM

Hospital laboratories throughout North America are successfully using “Lean” methods based on the Toyota Production System to win against multiple competitive threats. Some hospitals have used Lean to help eliminate point-of-care testing for the emergency department (ED). Other hospitals have used Lean to “insource” testing that had previously been done in outside reference laboratories. Lean can defend and protect employment for the laboratory, while also improving turnaround times and service for patients and reducing costs for the hospital. Hospital laboratories have also used freed up capacity to increase their reference laboratory work, bringing additional revenue to the hospital.

an improvement of 37%, as shown in Figure 1. The laboratory was also better satisfying physicians who ordered tests for morning rounds, as the percent of tests on the charts by 7 am improved from 65% to more than 90%, as shown in Figure 2. After laboratory professionals demonstrated that they could dramatically reduce turnaround times, the ED discontinued the point-of-care trials. Since Lean implementation, Dr. Decker said, turnaround times “are definitely faster. All the docs agree,” adding, “the lab is no longer the rate-limiting step in the process.”

Lean Instead of Point-of-Care Testing Before Lean, Riverside Medical Center, in Kankakee, IL, faced many challenges. Hospital CEO Phil Kambic explained, “Lab costs were skyrocketing, supply chain costs were increasing, performance was degrading in terms of turnaround times, and the emergency department was complaining.” The laboratory’s administrative director, Stephanie Mitchell, added, “Hospitalwide