Applicazione del Sistema Toyota alla fase pre-analitica come azione di miglioramento a seguito di un evento avverso: l’esperienza del Laboratorio Analisi dell’Istituto Fiorentino di Cura e Assistenza (IFCA)
Pre-Analitycal phase optimization through Lean Principles as a reaction to an adverse event: the experience of the laboratory service of the Istituto Fiorentino di Cura e Assistenza (IFCA)

AUTORI

ABSTRACT

Pre-Analitycal phase optimization through Lean Principles as a reaction to an adverse event: the experience of the laboratory service of the Istituto Fiorentino di Cura e Assistenza (IFCA)

Introduction: incident reporting and risk analysis are pivotal activities in the clinical laboratory to ensure patient safety. This paper describes an adverse event that occurred in February 2021 in the clinical laboratory of the Istituto Fiorentino Cura e Assistenza (IFCA) relating to a SARS-CoV-2 testing. Briefly, patients need a negative molecular test on a sample taken 2 days pre-operatively, but in one occasion a number of tests were not done on time due to a failure of the laboratory organization, and the surgery was postponed.
Methods: the subsequent analysis of the event showed that a rethinking of the entire pre analytical phase was necessary and the Toyota Production System (TPS) was used to establish a completely revised work flow.
Results: with the involvement of the entire laboratory staff and the support of a TPS specialist, the pathway was entirely redesigned: tubes colour codes were defined, dedicated working areas were implemented in order to obtain a space where the staff members can verify, at a glance, the status and the results of each step of the workflow.
Discussion: the application of the Toyota system to the pre-analytical phase of the laboratory has created a tidy and clean environment, with dedicated spaces for all the samples. The involvement of the staff in the improvement process has guaranteed the compliance of the operators to the new organisation.

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