Process analysis can be performed on the process map created during the measurement phase. The first step is to look for the most obvious problems that were observed. After the obvious problems are identified, the team should review the process to differentiate between value-added and non-value-added steps. Remember from the section on Lean earlier in the course, that waste is "anything other than the minimum amount of equipment, materials, parts, space, and worker's time that are necessary to add value to the product." Therefore value-added steps are those that are necessary to add value to the product. Keep in mind that it is not uncommon for an organization to have lots of non-value-added steps.
Obvious Problems
Observations:
- Lack of teamwork
- Too many manual steps
- Distance between sections too far
Conclusions:
- Limited understanding of the process
- Outdated technology and equipment
- The design of the laboratory is not based on the current need
Next steps:
- Cross-training and education
- Purchase cost-effective technology solutions
- Redesign the laboratory
Process steps
Construct a detailed process map identifying each step in the process, whether it is value-added (VA) or nonvalue-added (NVA), and why it is either VA or NVA.
| Process step | VA | NVA | Why VA or NVA? |
| Physician orders test through verbal or written order | X | | Regulatory agency requires physician orders to be documented. |
| RN or unit secretary enters order from chart | | X | Computerized physician order entry (CPOE) can be used |
| A label prints in the central lab area | | X | Label can be printed through a wireless printer |
| Lab assistant verifies all orders | | X | If the ordering physician places the order directly through CPOE, there is no need to double-check all orders |
| Lab assistant goes to the floor to collect the patient specimen | X | | Phlebotomy must be performed in person |
| Sample sent through tube system or hand-delivered to the laboratory tests | | | Tests performed in the central lab |
| Lab assistant takes samples to each lab area can | | | Can be automated using track system |
| Centrifugation | X | | Plasma/serum must be separated from cells prior to testing |
| Manual loading/unloading from centrifuge | | X | Automated system available for these tasks |
| Manual processing | X | | Not all procedures can be automated |
| Critical value and delta check flags | X | | Important for patient safety |
| Manual result verification | | X | Autoverification should be implemented |
