I am in the process of accomplishing one of my new years resolutions to become Black Belt certified in Lean Six Sigma. I am two thirds of the way done. I became certified as a Six Sigma Green Belt in April and Lean certified in June; both with a focus in healthcare. I am currently in the process of taking my black belt course and working on a project for certification. These days Lean Six Sigma methods are constantly running through my head and I have applied several methods to my consulting work.
One of my favorite tools are Post-its and take anywhere, disposable white boards. I use them on-site with clients and I also use them in my office, ALL over my office. So in an ongoing effort to immerse myself more in Lean Six Sigma for the lab I turned to one the leaders of Lean Six Sigma in pathology, Henry Ford Hospital.
Dr. Mark Tuthill, Division Head of Pathology Informatics, was kind enough to give me a tour and WOW was I impressed. Yes.. it was a big WOW! My last blog post was about creating WOWs instead of waiting for them to happen. This is exactly what Henry Ford’s department for Pathology and Laboratory Medicine has done and continues to do, because striving to improve is never complete! You know from the moment you enter the department you have walked into a remarkable place. Placards are prominently displayed with powerful messages including:
Every Life Deserves World-Class Laboratory Service”
Lean Six Sigma is a management philosophy and their department is lead by prominent pathologist Dr. Richard Zarbo, who clearly embraces the power of Lean Six Sigma. The entire department is involved and committed to continuous improvement; a fact that would make their founder, and the father of Lean, Henry Ford proud.
Here are some of my take-aways from my visit.
- Silence is golden! Dr. Tuthill brought to my attention, while standing in the gross lab, how quiet everything was. This quite and calm environment continued throughout the AP lab too. The department has moved away from transcription and voice dictation and developed templates that integrate into their LIS.
- Process improvement takes time and really is continuous. This is a fundamental of Lean Six Sigma but was reinforced throughout my department tour. White boards are all over to illustrate how new processes are mapped, monitored, and certain boards engage employees to document defects on an ongoing basis. Defects, as defined in their publication “Effective Reduction of Process Defects and Waste In Surgical Pathology,” are forms of waste including flaws, imperfections, or deficiencies in specimen processing that required work to be delayed, stopped, or returned to the sender. Here are some pictures of their whiteboards and process flow charts:
- A very visual environment. Everything, and I mean EVERYTHING was labeled- even gauze. The department loves 5S and Kanbans and you can tell. You never have to question where something is, where it should go, or if there is more available. It’s a straight forward concept but is your lab like that?
- A foundation for success! Henry Ford has been working hard to prepare their lab and department for their digital future over the past few years (while also reducing costs, improving patient safety, and laboratory efficiency). Their entire process is barcoded from accession to sign-out. The laboratory uses barcode technology from General Data, and even assigns barcodes to requisition forms that are scanned to eliminate paper in the lab. The gross lab is set up with a Milestone gross imaging system, digital cameras are mounted on grossing tables and pathologists microscopes. The cameras are then connected via a TWAIN interface to PathPacs, their middleware software by Apollo. PathPacs is integrated with their Sunquest CoPath Plus LIS and allows the pathologist to choose and select images to be in the LIS and reports.
Can you guess their next step for their digital future? Digital Pathology! With the foundation described above, a Lean Six Sigma culture, and a management team with vision I have no doubt that they will be successful. Thank you Henry Ford Hospital for your level of excellence, you truly are a gold standard.