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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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Process Analysis

Process analysis can be performed on the process map created during the measurement phase. The first step is to look for the most obvious problems that were observed. After the obvious problems are identified, the team should review the process to differentiate between value-added and non-value-added steps. Remember from the section on Lean earlier in the course, waste is "anything other than the minimum amount of equipment, materials, parts, space, and worker's time that are absolutely necessary to add value to the product." Therefore value-added steps are those that are absolutely necessary to add value to the product. Keep in mind that it is not uncommon for an organization to have lots of non-value added steps.
Obvious Problems
  • Lack of team work
  • Too many manual steps
  • Distance between sections too far
  • Limited understanding of the process
  • Outdated technology and equipment
  • Design of the laboratory is not based on current need
Next steps:
  • Cross-training and education
  • Purchase cost-effective technology solutions
  • Redesign the laboratory

Process steps
Construct a detailed process map identifying each step in the process, whether it is value-added (VA) or nonvalue-added (NVA), and why it is either VA or NVA.

Process stepVANVAWhy VA or NVA?
Physician orders test through verbal or written orderXRegulatory agency requires physician order to be documented.
RN or unit secretary enters order from chartXComputerized physician order entry (CPOE) can be used
Label prints in central lab areaXLabel can be printed through wireless printer
Lab assistant verifies all ordersXIf the ordering physician places the order directly through CPOE, there is no need to double-check all orders
Lab assistant goes to the floor to collect the patient specimenXPhlebotomy must be performed in person
Sample sent through tube system or hand-delivered to the laboratoryX Tests performed in the central lab
Lab assistant takes samples to each lab areaXCan be automated using track system
CentrifugationXPlasma/serum must be separated from cells prior to testing
Manual loading/unloading from centrifugeXAutomated system available for these tasks
Manual processingX Not all procedures can be automated
Critical value and delta check flagsX Important for patient safety
Manual result verificationXAutoverification should be implemented