title: The positive impact of simultaneous implementation of the BD FocalPoint GS Imaging System and lean principles on the operation of gynecologic cytology.
abstract: BACKGROUND
  Our cytology laboratory, like many others, is under pressure to improve quality and provide test results faster while decreasing costs. We sought to address these issues by introducing new technology and lean principles.
  
  
  OBJECTIVE
  To determine the combined impact of the FocalPoint Guided Screener (GS) Imaging System (BD Diagnostics-TriPath, Burlington, North Carolina) and lean manufacturing principles on the turnaround time (TAT) and productivity of the gynecologic cytology operation.
  
  
  METHODS
  We established a baseline measure of the TAT for Papanicolaou tests. We then compared that to the performance after implementing the FocalPoint GS Imaging System and lean principles. The latter included value-stream mapping, workflow modification, and a first in-first out policy.
  
  
  RESULTS
  The mean (SD) TAT for Papanicolaou tests before and after the implementation of FocalPoint GS Imaging System and lean principles was 4.38 (1.28) days and 3.20 (1.32) days, respectively. This represented a 27% improvement in the average TAT, which was statistically significant (P < .001). In addition, the productivity of staff improved 17%, as evidenced by the increase in slides screened from 8.85/h to 10.38/h. The false-negative fraction decreased from 1.4% to 0.9%, representing a 36% improvement.
  
  
  CONCLUSIONS
  In our laboratory, the implementation of FocalPoint GS Imaging System in conjunction with lean principles resulted in a significant decrease in the average TAT for Papanicolaou tests and a substantial increase in the productivity of cytotechnologists while maintaining the diagnostic quality of gynecologic cytology.
authors.affiliation: Department of Pathology, Yale University, New Haven, Connecticut 06525, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Wong
authors.forename: Angelique W
authors.initials: AW
authors.lastname: Levi
authors.forename: Malini
authors.initials: M
authors.lastname: Harigopal
authors.forename: Kevin
authors.initials: K
authors.lastname: Schofield
authors.forename: David C
authors.initials: DC
authors.lastname: Chhieng
mesh_terms: D000328:Adult; D003581:Cytodiagnosis / Q000295:instrumentation*; D003584:Cytological Techniques / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007755:Laboratories, Hospital; D065006:Papanicolaou Test; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D014626:Vaginal Smears / Q000295:instrumentation*; D057188:Workflow; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis