Optimizing the Supply Chain of Intensive Care Unit Blood Culture Samples to Clinical Microbiology Laboratory Using Lean Six Sigma

This paper targets the application of Lean Six Sigma (LSS) framework to microbiological diagnosis processes performed in a clinical microbiology laboratory of a tertiary level Spanish hospital.The increase in clinical samples and diagnostic requests during the COVID-19 pandemic led many microbiology laboratories to optimize their processes. Blood culture samples are one of the most critical cultures because a blood infection may endanger the individual's life. Not only the speed and quality of the diagnosis is important, but also the efficiency in the sample’s supply chain to the laboratory and its preservation conditions. To this end, the supply circuits of blood culture samples to the microbiology laboratory play a major role in the process, being the samples from intensive care units (ICUs) among the most critical. The work presents the analysis and optimization of the ordering and supply process of blood culture samples from an intensive care unit to a microbiology laboratory using LSS methodology and tools. The process starts with the blood culture’s order generation from the intensive care unit specialist and ends with the final reception of the blood culture sample in the pre-analytical area of the microbiology laboratory. The project is structured considering DMAIC problem-solving methodology. Main lean tools used for the supply process analysis and optimization were Gemba Walk, Value Stream Analysis (VSA) and mistake proofing. After project results validation with ICU and microbiology specialists, the next steps are the pilot implementation of the process improvement measures and their impact evaluation on the key performance indicators. The development of a lean concept, eliminating the waste and increasing the added-value of the blood culture samples ordering and supply process, improves the efficiency of the blood culture diagnosis process reducing the lead-time and impacting directly on the patient.