Impact of Lean Strategy on Gram Staining Procedure in Microbiology Laboratory
Article Sidebar
Main Article Content
Abstract
Background: The Gram staining procedure, a fundamental microbiological technique established in 1884, is crucial for bacterial identification and classification. Despite its significance, there is an ongoing need to enhance laboratory efficiency and reduce diagnostic turnaround times. Lean strategies, originating from Taiichi Ohno's work with Toyota, emphasize waste elimination and process improvement, offering a promising approach to optimizing laboratory operations.
Objective: This study aims to evaluate the impact of implementing Lean strategies on the efficiency of Gram staining procedures within a microbiology laboratory, focusing on reducing turnaround times and improving diagnostic precision without compromising quality.
Methods: A cross-sectional comparative study was conducted at the Department of Pathology, Combined Military Hospital, Lahore, from September to December 2022. Utilizing a non-probability convenience sampling technique, 122 samples were analyzed pre and post Lean implementation. Lean methodologies, including Just-In-Time inventory management and standardized work procedures, were applied to optimize sample transport, accessioning, processing, and staining phases. The study employed SPSS version 25 for statistical analysis, using the chi-square test to compare efficiencies, with a significance level set at p<0.05.
Results: Post-implementation of Lean strategies, significant reductions in non-value-added times were observed across all stages of the Gram staining process. Transport and accessioning times were reduced from 20 and 48 minutes to 15 and 30 minutes, respectively. The staining process time decreased from 121 to 104 minutes, and microscopy time was reduced from 201 to 56 minutes. Overall, the study reported a drastic decrease in non-value-added time from 825 to 56 minutes, maintaining the quality of staining results.
Conclusion: The application of Lean strategies to the Gram staining procedure significantly enhances laboratory efficiency by minimizing waste and optimizing process times. This approach not only improves diagnostic turnaround times but also maintains high-quality standards, suggesting a scalable model for broader healthcare system improvements.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Afum E, Sun Z, Agyabeng-Mensah Y, Baah C. Lean production systems, social sustainability performance and green competitiveness: the mediating roles of green technology adoption and green product innovation. Journal of Engineering, Design and Technology. 2021;21(1):206-27.
Akbulut Y, Usubütün A, Durur F, Kutlu G. Reducing turnaround time in a pathology laboratory using the lean methodology. International Journal of Lean Six Sigma. 2023;14(3):520-33.
Tripathi N, Sapra A. Gram staining. 2020.
Bhat S, Gijo E, Antony J, Cross J. Strategies for successful deployment and sustainment of Lean Six Sigma in healthcare sector in India: a multi-level perspective. The TQM Journal. 2023;35(2):414-45.
Boyanova L. Direct Gram staining and its various benefits in the diagnosis of bacterial infections. Postgraduate medicine. 2018;130(1):105-10.
Bui TI, Gill AL, Mooney RA, Gill SR. Modulation of gut microbiota metabolism in obesity-related type 2 diabetes reduces osteomyelitis severity. Microbiology Spectrum. 2022;10(2):e00170-22.
Chugh TD, Duggal AK, Duggal SD. Patient safety, clinical microbiology, and collaborative healthcare. Annals of the National Academy of Medical Sciences (India). 2022;58(03):128-35.
Dale AP, Gbesemete DF, Read RC, Laver JR. Neisseria lactamica controlled human infection model. Bacterial Vaccines: Methods and Protocols: Springer; 2021. p. 387-404.
De Schuyter K, Boelens J, Messiaen A-S, Schelstraete P, Verhasselt B, Huis In’t Veld D, et al. Rapid detection of S. pyogenes and S. pneumoniae in pleural fluid for diagnosis of parapneumonic empyema. European Journal of Clinical Microbiology & Infectious Diseases. 2024;43(1):195-201.
Gayer BD, Saurin TA, Anzanello M. The nature and role of informal resilience practices in the performance of lean production systems. Journal of Manufacturing Technology Management. 2022;33(6):1080-101.
Golder H, Denman S, McSweeney C, Celi P, Lean I. Effects of feed additives on rumen function and bacterial and archaeal communities during a starch and fructose challenge. Journal of Dairy Science. 2023;106(12):8787-808.
Johnson L, Hansy C, Chan H. MALDI‐TOF MS Implementation Strategy for a Pharma Company Based upon a Network Microbial Identification Perspective. Microbiological Identification using MALDI‐TOF and Tandem Mass Spectrometry: Industrial and Environmental Applications. 2023:453-71.
Khan SL, Haynatzki G, Medcalf SJ, Rupp ME. Clinical outcomes associated with blood-culture contamination are not affected by utilization of a rapid blood-culture identification system. Infection Control & Hospital Epidemiology. 2023:1-7.
Liu X, Qi G, Wu M, Pan Y, Liu B. Universal Fluorescence Light-Up Gram-Staining Technique for Living Bacterial Differentiation. Chemistry of Materials. 2021;33(23):9213-20.
Marodin G, Chiappetta Jabbour CJ, Godinho Filho M, Tortorella GL. Lean production, information and communication technologies and operational performance. Total Quality Management & Business Excellence. 2023;34(1-2):183-200.
Noronha A, Bhat S, Gijo E, Antony J, Laureani A, Laux C. Performance and service quality enhancement in a healthcare setting through lean six sigma strategy. International Journal of Quality & Reliability Management. 2023;40(2):365-90.
Noto G, Cosenz F. Introducing a strategic perspective in lean thinking applications through system dynamics modelling: the dynamic value stream map. Business Process Management Journal. 2021;27(1):306-27.
Pal J. Simple Laboratory Techniques For Fish Biochemistry And Microbiology Analysis: BFC Publications; 2023.
Parija SC. Laboratory Diagnosis of Bacterial Diseases. Textbook of Microbiology and Immunology: Springer; 2023. p. 319-38.
Sallam KI, Abd-Elghany SM, Hussein MA, Imre K, Morar A, Morshdy AE, et al. Microbial decontamination of beef carcass surfaces by lactic acid, acetic acid, and trisodium phosphate sprays. BioMed Research International. 2020;2020.
Shan K, Yao Y, Wang J, Zhou T, Zeng X, Zhang M, et al. Effect of probiotic Bacillus cereus DM423 on the flavor formation of fermented sausage. Food Research International. 2023;172:113210.
Shyrobokov V, Poniatovskyi V, Shylov M, Melnyk V, Yehorov D, Dolinchuk L, et al. Study guide of the practical classes course part І. 2020.
Simons CC, Capraro GA. Centralization versus Decentralization of Clinical Microbiology Laboratory Services: One More Choice To Make During a Global Pandemic. Clinical Microbiology Newsletter. 2020;42(23):187-91.
Sze DT, Lau CC, Chan T-M, Ma ES, Tang BS. Comparison of novel rapid diagnostic of blood culture identification and antimicrobial susceptibility testing by Accelerate Pheno system and BioFire FilmArray Blood Culture Identification and BioFire FilmArray Blood Culture Identification 2 panels. BMC microbiology. 2021;21:1-15.
van Daalen F, Smeulers M, Bartels E, Holleman F, Visser C, Geerlings S. A healthcare failure mode and effect analysis to optimise the process of blood culture performance. Netherlands Journal of Medicine. 2020;78(6):341-8.
Vandenberg O, Durand G, Hallin M, Diefenbach A, Gant V, Murray P, et al. Consolidation of clinical microbiology laboratories and introduction of transformative technologies. Clinical microbiology reviews. 2020;33(2):10.1128/cmr. 00057-19.
Ye J, Huang S, Jin J, Wei X. Improvement of the silver staining method for bacterial flagella. Journal of Microbiological Methods. 2022;198:106495.
Quetz JdS, Lima IF, Havt A, Prata MM, Cavalcante PA, Medeiros PH, et al. Campylobacter jejuni infection and virulence-associated genes in children with moderate to severe diarrhoea admitted to emergency rooms in northeastern Brazil. Journal of medical microbiology. 2012;61(4):507-13.
Sugianto JZ, Stewart B, Ambruzs JM, Arista A, Park JY, Cope-Yokoyama S, et al. Applying the principles of lean production to gastrointestinal biopsy handling: from the factory floor to the anatomic pathology laboratory. Laboratory medicine. 2015;46(3):259-64.
Poksinska B. The current state of Lean implementation in health care: literature review. Quality management in healthcare. 2010;19(4):319-29.