A-109 Application of Lean Manufacturing in Electrophoresis Test Processing in Order to Reduce Lead Time
Authors: Oliveira J R , Escalante I B , Fernandes I R , Carrero K F , Costa P G , Jacomo R H , Abdalla L F 
Published: September 2023

Abstract

Background
There has been an increase on the demand for Protein Electrophoresis and Hemoglobin Electrophoresis exams over the past few years. This growth drew attention and motivated the laboratory’s Production Planning and Control (PPC) team to carry out a process flow analysis of the electrophoresis samples coming from the external units, which are responsible for approximately 60% of the total samples analyzed of these two exams. The study aimed to minimize waste throughout the process, optimize the use of resources, standardize continuous flows of activities, and reduce the Turnaround Time (TAT) of the samples in question, disseminating Lean culture and increasing the satisfaction of internal and external customers.

Methods
In order to reduce the TAT of electrophoresis exams from external units, the PPC team carried out on-site visits and revised the entire flow of processes related to these exams and others that could indirectly influence it, from collection and transport until the analyst’s signature and release of the result to the patient, mapping the entire flow covered by the samples and identifying possible important bottlenecks inherent to the activities, aiming at possible opportunities for improvement, through interviews, brainstorming, flowcharts and Design Thinking. Data such as the volume of monthly tests, percentage of external samples, TAT at the regional units, TAT at the Immunochemistry sector and total TAT were extracted from the laboratory’s automated data system and analyzed by the PPC team. With this, it was possible, through the Pareto analysis, to prioritize the obstacles to be overcome and focus on the main identified bottleneck, the amount of time for signing and releasing the reports, in addition to focusing on the random flow between the receiving and triage area and the processing technical area.

Results
Upon discovering that the greatest impact on processing time was located in the post-analytical phase of signing and releasing of the reports we suggested the capacitation of three extra analysts for the execution of the mapped action, the retraining of the technicians of the sectors responsible for the distribution of samples and supply of the machines and the standardization of a continuous flow between the areas, strengthening the Lean philosophy and the FIFO dynamics (First in—First out). Thus, we obtained a considerable decrease in the TAT of protein and hemoglobin electrophoresis, in which the total TAT of the operation was reduced by approximately 34% and the TAT referring to the time inside the Center of Technical Operations (CTO) by approximately 40%.

Conclusion
With the implementation of the above mentioned processes and the use of the Lean philosophy, the laboratory was able to considerably optimize the TAT of the Hemoglobin and Protein Electrophoresis exams, in addition to training employees to release results and enhance the standardization of receipt processes and distribution of these samples, with this, it was possible to optimize resources, increase the productivity of the sector, reduce the time of patient care and consequently maximize added value to the service.