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Implementation of a ‘lean’ cytopathology service: towards routine same-day reporting
  1. Ekkehard Hewer,
  2. Caroline Hammer,
  3. Daniela Fricke-Vetsch,
  4. Cinzia Baumann,
  5. Aurel Perren,
  6. Anja M Schmitt
  1. Institute of Pathology, University of Bern, Bern, Switzerland
  1. Correspondence to Dr Ekkehard Hewer, Institute of Pathology, University of Bern, Murtenstrasse 31, 3010 Bern, Switzerland; ekkehard.hewer{at}


Objectives To systematically assess the effects of a Lean management intervention in an academic cytopathology service.

Methods We monitored outcomes including specimen turnaround times during stepwise implementation of a lean cytopathology workflow for gynaecological and non-gynaecological cytology.

Results The intervention resulted in a major reduction of turnaround times for both gynaecological (3rd quartile 4.1 vs 2.3 working days) and non-gynaecological cytology (3rd quartile 1.9 vs. 1.2 working days). Introduction of fully electronic reporting had additional effect over continuous staining of slides alone. The rate of non-gynaecological specimens reported the same day increased from 4.5% to 56.5% of specimens received before noon.

Conclusions Lean management principles provide a useful framework for organization of a cytopathology workflow. Stepwise implementation beginning with a simplified gynaecological cytology workflow allowed involved staff to monitor the effects of individual changes and allowed for a smooth transition.

  • laboratory management
  • cytology
  • reports

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  • Handling editor Dhirendra Govender.

  • Contributors EH, AP and AMS designed the study. EH, CH, DF-V, CB and AMS analysed the data. EH drafted the manuscript. All authors read and approved the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.