Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

Laboratory turnaround time for urgent BUSE request

Mahaya CM*, Nik MM*, Muniamal K*, Zaiton K*, Tong WT*

*Hospital Raja Perempuan Zainab II, Kelantan, **Institute for Health Systems Research, Ministry of Health Malaysia, Kuala Lumpur

ABSTRACT

Introduction: Lean thinking is not used as a cost-reduction tactic, but a management strategy that is applicable to all organisations to improve the processes. The current average time for producing Blood Urea Serum Electrolytes (BUSE)/Renal Profile results take up to 2 hours at the Laboratory Department of Hospital Raja Perempuan Zainab II, Kota Bharu. According to National Indicator Approach (NIA), the laboratory turnaround time for urgent BUSE/Renal Profile less than 60 minutes in more than 90% of the request. The main aim is to achieve laboratory turnaround time for urgent BUSE/ renal profile within 60 minutes in more than 90% of the request.

Method: LEAN was carried out at the Laboratory Department of Hospital Raja Perempuan Zainab II, Kota Bharu for 6 months with the aim to reduce the process time of urgent Blood Urea Serum Electrolytes (BUSE) /Renal Profile. Value stream mapping is a LEAN method where each steps of processing BUSE/ Renal profile was described in detail. The total process time including value added and non- value added are mapped out and calculated. Focus is given to processes with long waiting time and wastes at that area are identified. Improvement opportunities (kaizen burst) are identified in preparation for future state value stream mapping. Unnecessary processes are identified and eliminated. Steps in demography and sorting of samples are combined and simplified by using SPPV 3.1 system which makes the registration and priority identification of samples easier and faster.

Results: After 6 months, the laboratory turnaround time for urgent renal profile/ BUSE within 60 minutes improved from 25% to 77.3% and the average total time improved from 78.5 minutes to 50 minutes after LEAN implementation.

Conclusion: Utilizing the LEAN approach, the laboratory turnaround time for urgent BUSE/ renal profile has improved.

Keywords: Lean healthcare, waiting time, value stream mapping, kaizen burst, renal profile/ BUSE, laboratory turnaround time