Management in healthcare
  • 2022 № 5 Review of lean practices in clinical laboratories

    The main role of clinical laboratory diagnostics is to obtain reliable, reproducible and timely results that help to make the right clinical decisions. As the literature review shows, there are a number of common problems for many clinical laboratories, such as: long turnaround times, high laboratory costs for consumables, insufficient level of satisfaction with quality of services received by patients and high number of complaints. The use of lean manufacturing can be one way of solving these problems.
    Purpose of the study is to summarize and analyze the literature regarding the application of lean manufacturing in clinical laboratories.
    Materials and methods. A literature review was performed using the following abstract databases: Web of Science, Scopus, PubMed, ScienceDirect, Mendeley, and NCBI. The depth of the search according to the time parameter had no limitations. The following keywords were used as search markers: “lean management”, “lean thinking”, “lean six sigma”, “lean tools”, “healthcare”, “health services”, “clinical laboratory”. More than 100 publications were analyzed, from which 28 most representative studies were selected.
    Results. The implementation of lean production methods provides a reduction in turnaround time, costs and errors in the clinical laboratory, reduces the contamination of biological material at the preanalytical stage and reduces waiting time for services and, as a consequence, reduces the number of patient complaints.
    Conclusion. The above results indicate that lean production methods can be used in laboratories to solve frequently occurring problems and demonstrate the effectiveness of their application in clinical laboratories.

    Authors: Shibalkov I. P. [8] Boykov V. A. [7] Kobyakova O. S. [16] Deev I. A. [9] Baranovskaya S. V. [4] Babeshina M. A. [2] Pavlova K. A. [1] Perfilyeva D. Yu. [1]

    Tags: clinical laboratory2 cost reduction1 lean  production6 patient satisfaction7 turnaround time (tat)1

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  • 2021 № 1 Applying lean manufacturing technologies to optimize ambulance operations amid the spread of COVID‑19

    The pandemic of new coronavirus infection COVID‑19 has become a serious challenge for the national health
    systems, including Russia, setting ambitious goals aimed at preventing the spread of infection and maintaining the availability of medical care in environment of increasing pressure. The aim of the study was to develop, based on the principles of lean production, a set of measures to increase the availability of emergency medical services for patients diagnosed with or suspected of a new coronavirus infection COVID‑19 in the Tomsk Region. Standard tools of lean manufacturing are applied to the work process of the admission department of the respiratory center in RSBHI «Medical sanitary station № 2». As a result of implementation of target state map, which provides for the optimization of process of transferring a patient diagnosed or suspected of a new coronavirus infection COVID‑19 to admission department, a positive dynamics of local (5.4 times increase in the proportion of calls completed within 15 minutes after the patient was delivered to the admission department) and system (an increase of 1.3 times in the proportion of calls with the time the ambulance team reaches the patient within 20 minutes) indicators of the ambulance service was achieved. The study confirms the effectiveness of lean manufacturing tools for optimizing the work of ambulance and allows us to recommend them for use in a pandemic and other risks of emergency.

    Authors: Shibalkov I. P. [8] Boykov V. A. [7] Kobyakova O. S. [16] Deev I. A. [9] Taranov A. A. [2] Baranovskaya S. V. [4] Suvorova T. A. [3] Babeshina M. A. [2] Masunov V. N. [1] Milkevich M. N. [1] Rodionov N. V. [1]

    Tags: covid-19 pandemic6 emergency medical services2 lean  production6 patient routing1 respiratory center1

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