Optimization of laboratory exam processes in a state emergency room: application of lean healthcare integrated with the DMAIC methodology
healthcare management; emergency hospital services; medical testing
This study aimed to optimize the laboratory testing process in a state emergency department, with the goal of reducing overcrowding and increasing bed turnover. The Lean Healthcare methodology, integrated with the DMAIC cycle, was applied in an applied, exploratory, and descriptive study, adopting a mixed-methods and action-research approach. The diagnostic phase results revealed long intervals between test requests, collection, and release, an average length of stay of 7.4 days, and a bed occupancy rate of 213.5%, well above recommended standards. The analysis identified shortcomings such as the absence of standardized protocols, ineffective communication, and understaffing. As an intervention, an action plan with 12 measures was developed, including test bundles, medical training, formalized workflows, and an alert system. Expected outcomes include reducing laboratory turnaround time, improving bed turnover, and enhancing patient safety.