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HMHEB Clinical Laboratory is First in North Texas to Implement Lean Processing System
05/08/2006

BEDFORD, Texas – At first glance, an automobile manufacturing plant and a community hospital have little in common. But speed and customer service underlie both industries – manufacturers need to quickly get quality products to market before their competitors and hospitals need to quickly and accurately disseminate patient information to caregivers. Harris Methodist H•E•B Hospital's clinical laboratory is the first in North Texas to implement lean processing, an innovative manufacturing process developed by Japanese car manufacturers, that allows the laboratory to return test results to physicians more quickly.

The automotive industry is known for its innovative manufacturing process, called “lean manufacturing.” Lean is based on several principles that can be adapted in other industries, including certain aspects of health care:

  • zero waiting time,
  • zero inventory, and
  • reduced process times.

In the laboratory at HMHEB, it was essential to provide clinical laboratory results to physicians so they can quickly diagnose and treat patients. This enables patients to be discharged more rapidly, resulting in improved patients satisfaction as well as cost savings for both the hospital and the patients.

“Essentially, lean processing is all about eliminating waste – waste of time, wasted space, wasted supplies and resources,” said Sharon Harris, MS, MT (ASCP) SBB, director of the laboratory at HMHEB. “We run close to 725,000 different tests every year. Since we play such a critical role in patient care, it's essential we have the most efficient processes possible. Our overarching goal is always to improve patient safety and quality.”

To reduce processing time, the laboratory made several changes that significantly impacted operations, including:

  • Grouping all automated instruments together so one technician can operate them all at once. This is the most high volume area, producing 80 percent of laboratory orders.
  • Manual processes are in a different part of the lab, overseen by technicians who concentrate on those processes.
  • Developing visual indicators using color coding so technicians can quickly see what work needs to be done, what is complete and where things need to go next.
  • Installing an automated archiving program to quickly locate specimens within the lab. This database uses barcode technology to tell users exactly where a specimen is in the lab and where it is in the order process. When physicians need additional labs performed on a specimen, technicians can easily locate the specimens and add the new tests. Originally, the time it took to find a specimen in the lab was 30 minutes – now it takes only five.
  • Technicians are also cross-trained more easily, which decreases labor requirements and helps if a team member is out sick or on vacation.

Inventory was also impacted, so fewer resources were tied up in unnecessary inventory and supplies were readily available when they were needed. Changes included:

  • Implementing a central “supermarket” where everyone goes for supplies, reducing the time spent looking for inventory items.
  • Designing a visual system so technicians can easily see where things are and what you need to reorder, allowing for better control of inventory.
  • More frequently used items are at arms length eliminating the need to reach for things, which saves time and effort.
  • A technician regularly visits the nursing stations to replenish their supplies so they never run out, allowing nurses to spend more time with patients.
  • In the future, the laboratory is planning to implement an automated ordering system.

Since implementing lean processing, the laboratory is much more efficient – processing times have been reduced by almost half. Employee, physician and patient satisfaction is improved, and floor space was reduced by 13 percent, eliminating the need for extra space. The labs most frequently ordered by the Emergency Department, cardiac and pregnancy tests, have been reduced from 60 minutes to 45 minutes and from 60 minutes to 30, respectively.

In the future, other areas of the laboratory will go through the lean processing process, and the GI Lab is currently developing plans to “lean out” its area.

About Harris Methodist H•E•B Hospital
Harris Methodist H•E•B Hospital, a member of Texas Health Resources, is a 284-bed, acute-care facility serving Northeast Tarrant County since 1973. Services provided at Harris Methodist H•E•B Hospital include outpatient surgery, women's services, a level III neonatal intensive care unit, a dedicated oncology care unit, neurosurgery, cardiovascular surgery and a dedicated cardiac care unit, cardiac rehabilitation, physical medicine and rehabilitation, occupational health services, psychiatric and addiction treatment and pediatrics.

About Texas Health Resources
Texas Health Resources is one of the largest faith-based, nonprofit health care delivery systems in the United States. The 13-hospital system is the largest in North Texas in terms of patients served and includes the Harris Methodist Hospitals, Arlington Memorial Hospital and Presbyterian Healthcare System. For more information about Texas Health Resources, visit http://www.texashealth.org/.

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