The Lean-enabled Device

Nexus is a management consulting company that works with laboratories and healthcare IVD companies to help create a more effective laboratory operational environment. In this capacity, we are frequently asked to identify the analyzer, instrument, automation or other device that will help make the laboratory more efficient.   Sometimes this is not a simple answer, and depending on the situation and operational characteristics of the laboratory, there could be many correct answers. However, the industry is in general agreement that the Lean philosophy toward lab operations will ultimately create a more streamlined and effective lab that will reduce waste (to include testing errors) and more frequently meet the expectations of the customer(s).

The outcome of Lean in the clinical and pathology laboratory usually takes the form of Lean Lab initiatives. Generally, Lean Lab initiatives accomplish the following:

1. Compress the chain of events leading to the test result by eliminating the steps that are not of value to the customer
2. Organize the work area through an ongoing process of cleaning and sorting
3. Ensuring the physical environment is streamlined
4. Creating a flexible operational environment
5. Installing items and features that will dramatically decrease the opportunity for human error

A Lean-enabling device (such as a clinical laboratory analyzer) is one that makes it easier to accomplish the above initiatives. Characteristics of Lean-enabled instruments might include:

• Continuous, random access devices that can be operated in small batches, or even handle a single patient at a time
• Instrument requires little labor input relative to output (human interfacing)
• Instrument requires little labor input relative to output (electronic interfacing)
• Instrument generates test results faster than other options
• Instrument has the flexibility to prioritize certain work (i.e., STAT tubes) without affecting the main work processes
• Flexible modes that allow for quick change over when needed or walk away ability
• Relatively small instrument and functional footprint
• Flexibility to be moved or integrated with other devices or informatics as needed
• Poke-yoke features that minimize human error
• Instrument uses relatively few consumables and generates relatively little waste compared to the output

So, when answering the question of which device is more effective, we usually revert back to the criteria above. If a device meets many, if not all, of these characteristics they will help the lab manager to accomplish Lean goals. It is important to point out that no device will create a Lean environment for you. Rather, the some devices are more suited to better enabling Lean initiatives.