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. 2012 Jan;18(1):57-62.
doi: 10.3201/eid1801.101485.

Use of Lean response to improve pandemic influenza surge in public health laboratories

Judith L Isaac-Renton  1 , Yin Chang, Natalie Prystajecky, Martin Petric, Annie Mak, Brendan Abbott, Benjamin Paris, K C Decker, Lauren Pittenger, Steven Guercio, Jeff Stott, Joseph D Miller
Affiliations

Use of Lean response to improve pandemic influenza surge in public health laboratories

Judith L Isaac-Renton et al. Emerg Infect Dis. 2012 Jan.

Abstract

A novel influenza A (H1N1) virus detected in April 2009 rapidly spread around the world. North American provincial and state laboratories have well-defined roles and responsibilities, including providing accurate, timely test results for patients and information for regional public health and other decision makers. We used the multidisciplinary response and rapid implementation of process changes based on Lean methods at the provincial public health laboratory in British Columbia, Canada, to improve laboratory surge capacity in the 2009 influenza pandemic. Observed and computer simulating evaluation results from rapid processes changes showed that use of Lean tools successfully expanded surge capacity, which enabled response to the 10-fold increase in testing demands.

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Figures

Figure 1
Figure 1
Seasonal influenza testing processes (pre-kaizen value stream). NAT, nucleic acid amplification techniques; RT-PCR, reverse transcription PCR.
Figure 2
Figure 2
Pandemic (H1N1) 2009 testing processes (post-kaizen with the flow cells depicted as processes occurring within a box). RT-PCR, reverse transcription PCR.
Figure 3
Figure 3
Number of respiratory samples tested by the British Columbia (Canada) Public Health Microbiology & Reference Laboratory in the 2008–09 influenza season compared with the pandemic (H1N1) 2009.
Figure 4
Figure 4
Simulated pandemic FluSurge level of daily test volume demand showing British Columbia (Canada) Public Health Microbiology & Reference Laboratory seasonal capacity estimated to be 231 samples per day and postemergency (kaizen) pandemic capacity 528 samples per day.
Figure 5
Figure 5
Simulated back-log using seasonal and postemergency (kaizen) pandemic processes with a FluLabSurge (1968 pandemic) level of expected test demand for population, British Columbia, Canada.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Swine influenza A (H1N1) infection in two children—southern California, March–April 2009. MMWR Morb Mortal Wkly Rep. 2009;58:400–2. - PubMed
    1. Health Canada. Appendix C: pandemic influenza laboratory guidelines. In: The Canadian pandemic influenza plan for the health sector. Ottawa (ON): Health Canada; 2006. [cited 2010 Feb 22]. http://www.phac-aspc.gc.ca/cpip-pclcpi/pdf-e/cpip-eng.pdf
    1. Fouchier RA, Bestebroer TM, Herfst S, Van Der Kemp L, Rimmelzwaan GF, Osterhaus AD. Detection of influenza A viruses from different species by PCR amplification of conserved sequences in the matrix gene. J Clin Microbiol. 2000;38:4096–101. - PMC - PubMed
    1. Porche RA Jr, ed. Doing more with less: Lean thinking and patient safety in health care. Chicago: Joint Commission Resources; 2006.
    1. Joint Commission Resources. Advanced Lean thinking: proven methods to reduce waste and improve quality in healthcare. Oakbrook Terrace (IL): Joint Commission Resources; 2008.

MeSH terms