Henry Ford Health System Researchers Develop System To Reduce Defects And Improve Quality In The Lab, USA

Main Category: Public Health
Article Date: 25 Aug 2007 - 1:00 PDT

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Pathologists and laboratory professionals at Henry Ford Health System in Detroit, MI have adopted an innovative and highly successful process improvement system that is changing the way laboratories deliver test results to doctors and patients.

As the 15th largest lab in the United States, processing more than 6.5 million specimens annually, Henry Ford's labs had many of the same process issues endemic to labs everywhere. Researchers there decided to take the advice of their founder, automotive pioneer Henry Ford, and adopted his underlying production principles to maximize the efficiencies and qualities in the labs.

Their research findings, which describe their method to reduce errors and improve lab quality, will be published in the September 2007 issue of the American Journal of Clinical Pathology (AJCP). In the publication, researchers share simple yet novel approaches to data collection that led to worker-identified sources of waste, defects, and misidentifications that result in lost time and rework.

Researchers found that through deep and honest self analysis and the concerted effort of all workers, they could identify inefficiencies in their process. This knowledge formed the structure for effective changes to strive toward a zero-defect performance goal. Data were collected during two weeks of routine service by 57 personnel in surgical pathology for 1,690 surgical pathology cases. (Surgical pathology involves the examination of surgical tissue specimens, as well as biopsies for definitive diagnosis of disease.)

The new system has resulted in more than 100 improvements, each making a small but effective enhancement to the quality and timeliness of care. For instance, they have implemented the use of bar code-specified work processes to reduce specimen identification and work product defects, and results for routine biopsies have improved from 73 percent being completed in one day to 92 percent being completed in one day.

"The Henry Ford Production System is not just about waste reduction but adopts the best of the Toyota Production System's approach to people," said co-lead researcher Richard J. Zarbo, MD, DMD. "To be successful in using manufacturing-based approaches to quality requires nothing less than a complete cultural shift in the American workplace that gives every worker and manager a way to design their work in a blame-free and cooperative environment thereby unleashing their profound creative potential."

Zarbo and co-author Rita D'Angelo, MS, ASQ CQE, SSBB found most helpful the use of a mounted visual data display poster to enter defects, rate their importance and their root causes. Six Sigma performance metrics were then utilized to make choices to improve quality.

The team redesigned specimen sorting to eliminate redundant steps, standardized tissue size to eliminate cassette opening during processing, and implemented action alerts to flag cases for critical values.

To read the full research study article that appears in AJCP, please click here or visit this link.

http://www.ascp.org