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[Contribution and limits of lean management in the organization and working of a pathology department].

Authors
  • Ramla, Selim1
  • Funes de la Vega, Mathilde1
  • Tarris, Georges1
  • Pap, Veronique1
  • Aubignat, Damien1
  • Dubois, Lyse Marie2
  • Andrianiaina, Haingo1
  • Bretagne, Charles Henri1
  • Millière, Alice1
  • Tournier, Benjamin3
  • Harizay, Fara1
  • Douchet, Catherine1
  • Callanan, Mary4
  • Falatin, Christophe5
  • Chapusot, Caroline3
  • Aubriot-Lorton, Marie Hélène2
  • Martin, Laurent6
  • 1 Service de Pathologie, CHU Dijon, Dijon, France. , (France)
  • 2 Service de Pathologie, CHU Dijon, Dijon, France; Plateforme de Génétique somatique des cancers de Bourgogne, CHU Dijon. , (France)
  • 3 Plateforme de Génétique somatique des cancers de Bourgogne, CHU Dijon; UF d'innovation en Génétique et épigénétique des cancers solides et des hémopathies malignes, CHU Dijon, Dijon, France. , (France)
  • 4 UF d'innovation en Génétique et épigénétique des cancers solides et des hémopathies malignes, CHU Dijon, Dijon, France. , (France)
  • 5 Cabinet de conseil, ACE SANTE, Lyon, France. , (France)
  • 6 Service de Pathologie, CHU Dijon, Dijon, France; Plateforme de Génétique somatique des cancers de Bourgogne, CHU Dijon; UF d'innovation en Génétique et épigénétique des cancers solides et des hémopathies malignes, CHU Dijon, Dijon, France. Electronic address: [email protected] , (France)
Type
Published Article
Journal
Annales de Pathologie
Publisher
Elsevier
Publication Date
Apr 01, 2021
Volume
41
Issue
2
Pages
176–185
Identifiers
DOI: 10.1016/j.annpat.2020.06.012
PMID: 32646777
Source
Medline
Keywords
Language
French
License
Unknown

Abstract

In order to validate our strategy of continuous improvement and to identify new ways to increase performance, an evaluation of all the procedures was conducted in our department using the principles of lean management. Lean-6-sigma methodology (Gemba Walk, Value StreamMapping, spaghetti diagram, Kaizen workshop and priorization matrix) was used to analyze the procedures of the conventional and molecular sectors, and to identify bottlenecks, actions without added value and solutions. The audit identified bottlenecks in pre-analytical (registration), analytical (cytology, immunohistochemistry, sequencing, pathologists) and post-analytical processes (absence of secretaries, delivery of reports by mail). It underlined a suboptimal flow of people and materials, the heavy impact of an increasing work load (8%/year) in reception and microscopy even though we had outsourced, and an often critical work place schedule for technicians which prevent them from achieving tasks without added value (quality control, validation of methods and protocols) or even daily tasks (cutting, immunohistochemistry). After completing the 72 actions aimed at managing overproduction, improving working conditions and developing new activities, turn-around time was partially under control and the automation process was well advanced. The audit validated our strategy of continuous improvement and advanced the standardization of our working conditions. Even if the turn-around time for reports was shortened, the audit initiated a positive medical and technical dynamic that should help us to implement the next steps of our reorganization (automation and extension of the department). Copyright © 2020 Elsevier Masson SAS. All rights reserved.

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