title: The combined positive impact of Lean methodology and Ventana Symphony autostainer on histology lab workflow.
abstract: BACKGROUND
  Histologic samples all funnel through the H&E microtomy staining area. Here manual processes intersect with semi-automated processes creating a bottleneck. We compare alternate work processes in anatomic pathology primarily in the H&E staining work cell.
  
  
  METHODS
  We established a baseline measure of H&E process impact on personnel, information management and sample flow from historical workload and production data and direct observation. We compared this to performance after implementing initial Lean process modifications, including workstation reorganization, equipment relocation and workflow levelling, and the Ventana Symphony stainer to assess the impact on productivity in the H&E staining work cell.
  
  
  RESULTS
  Average time from gross station to assembled case decreased by 2.9 hours (12%). Total process turnaround time (TAT) exclusive of processor schedule changes decreased 48 minutes/case (4%). Mean quarterly productivity increased 8.5% with the new methods. Process redesign reduced the number of manual steps from 219 to 182, a 17% reduction. Specimen travel distance was reduced from 773 ft/case to 395 ft/case (49%) overall, and from 92 to 53 ft/case in the H&E cell (42% improvement).
  
  
  CONCLUSIONS
  Implementation of Lean methods in the H&E work cell of histology can result in improved productivity, improved through-put and case availability parameters including TAT.
authors.affiliation: University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Lewis A
authors.initials: LA
authors.lastname: Hassell
authors.affiliation: OU Medical Center, Oklahoma City, Oklahoma, USA.
authors.forename: Crystal F
authors.initials: CF
authors.lastname: Glass
authors.affiliation: Ventana Medical Systems, Tucson, AZ, USA.
authors.forename: Clinton
authors.initials: C
authors.lastname: Yip
authors.affiliation: OU Medical Center, Oklahoma City, Oklahoma, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Eneff