Implementation of a ‘lean’ cytopathology service: towards routine same-day reporting

Hewer, Ekkehard; Hammer, Caroline; Fricke-Vetsch, Daniela; Baumann, Cinzia; Perren, Aurel; Schmitt, Anja M. (2018). Implementation of a ‘lean’ cytopathology service: towards routine same-day reporting. Journal of clinical pathology, 71(5), pp. 395-401. BMJ Publishing Group 10.1136/jclinpath-2017-204504

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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.

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