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The page below is a sample from the LabCE course Basics of Lean and Six Sigma for the Laboratory. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Additional Lean Processes and Concepts

In addition to 5S and the waste walk, other tools are considered essential in a Lean system. These tools are listed below:
Lean Process/Concept
DefinitionLaboratory Application
Pull system
A system where supply and production are dependent on demand.
Instead of ordering the same amount of supplies on a fixed time interval, a laboratory utilizing a pull system would review data from the analyzer test counter or take inventory to match the order to the testing demand.
Continuous flow
One-for-one process. No waiting between steps. Linking the rate of demand to the rate of production.
Patient moves from registration to blood draw area to doctor without waiting.
Blood sample arrives in the laboratory, is received, processed, and tested immediately rather than waiting to batch.
Set up reduction
Preparation of the work area and supplies in advance so that the process proceeds smoothly.
Set up supplies into ready-to-use kits. Perhaps these can be set up by the prior shift during slow times.
A system that doesn't allow a worker to make a mistake. Activities or methods that prevent defects from occuring. Can be used in combination with visual signals.
Many point-of-care instruments have automatic lockout of testing if quality controls are not tested, or if they fail, prior to patient testing.
Value stream map
A picture that illustrates the flow of material, inventory, and product. Value stream maps are used for value stream analyses, which can allow an organization to identify waste in its processes through Lean thinking. The value stream map should start from the supplier and end at the customer. Within that general framework, it should be recognized that each process in the workflow is the "customer" of the previous upstream process. In a clinical laboratory the start would be when the physician place the order or when the courier drop off the sample. And the end would be when the results are sent to the client or physician. Different processes: preanalytic, analytic, and postanalytic within the laboratory are included in between. The value stream map can help to identify unneeded or non-value-adding steps and provide a high level review of the entire process.
Takt time and level loading
Takt time is a measurement of the process flow over time that will help determine how to combine work to achieve the best flow. Based on the takt time, level loading helps to balance the volume and variety of work among employees so that work progresses at a more even pace.
Cross-training allows a laboratory worker to help in another department when there is a lull in their department's workflow.