A-195 Combination of Lean Mindset, Robotics and Digitalization allowed us to manage a 2.5 times increase in workload in our central reference lab
Authors: Bansal A , Datta R R , Bhakta S , Shaikh S , Manjure A 
Published: October 2024

Abstract

Background
Our Agilus Diagnostics, Gurugram, India is a Central Reference Laboratory and part of the pan-India network over 400 lab in India. Our Gurugram lab delivers 3,200 tubes in the serum work area in 17 hour operations daily and is ISO 15189 and CAP accredited.In Jan 2023, our lab started to support Govt PHC Program samples and our workload increased to 8000 tubes. This was a clear operational and clinical challenge for us with a 2.5 x jump in workload. To achieve this goal, a lean mindset with process improvement steps were to be applied required across the total testing process. This lean approach was supported by cobas ® Lab Automation systems managed by navify ® Lab Operations informatics automation solution. This poster explains our journey of planning, implementing, and delivering on our goal of predictable operational efficiency when faced with this challenge.

Methods
We took 4 major steps
We redesigned lab processes using lean process improvement operational dashboards. This poster will show the metric we track which help eliminate waste in the system.
We optimized our total lab automation solution with smart load balancing across cobas ® Pro integrated analyzers and staff friendly recursive workflow.
Clear and strict use of off peak hours for maintenance and QC procedures and standardized predictable schedule of operation. This poster will share our time table with key milestones across the 24 hours
We built on the Informatics solution using 5 layered Auto verification rules based decision framework. IQC, Systems Flags check, Sample Quality checks, Biological Reference check, custom Auto verification Range, Critical ranges Delta check Criteria, Clinical Correlation Rule are all part of the auto verification logic framework.

Results
We were able to deliver the following results.Lean process design led to 53% simplification. Number of process steps reduced to 29 from 62 steps across the total testing process.
Total Lab Automation has helped improve 90 percentile production TAT by 46% from 250 mins to 135 mins
Our 90 % TAT CV has significantly reduced making our production predictable.
Over 17,500 results / day reported are subject to auto verification with 87 % of all results auto-verified and auto-approved.
Not a single additional employee was added in the analytical or post analytical areas of the lab operations

Conclusions
Lean Mindset complemented by Total Laboratory Automation along with Decision Automation on an Informatics solution has enhanced lab performance in terms of TAT, Efficiency, and Staff Motivation.
This poster will also demonstrate using incremental effectiveness analysis comparative data of key performance indicators, such predictability in production, and efficiency of workforce, senior staff time saved, before and after technology deployment.
The challenge of increase in sample workload is real in India and this approach allows for a sustainable way to ensure patient impact with minimum burden on our workforce.