PT  - JOURNAL ARTICLE
AU  - Ekkehard Hewer
AU  - Caroline Hammer
AU  - Daniela Fricke-Vetsch
AU  - Cinzia Baumann
AU  - Aurel Perren
AU  - Anja M Schmitt
TI  - Implementation of a ‘lean’ cytopathology service: towards routine same-day reporting
AID  - 10.1136/jclinpath-2017-204504
DP  - 2017 Sep 30
TA  - Journal of Clinical Pathology
PG  - jclinpath-2017-204504
4099  - http://jcp.bmj.com/content/early/2017/09/30/jclinpath-2017-204504.short
4100  - http://jcp.bmj.com/content/early/2017/09/30/jclinpath-2017-204504.full
AB  - 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.