OBJECTIVE: The objective of the study was to determine whether the Toyota production system process improves Papanicolaou test quality and patient safety. STUDY DESIGN: An 8-month nonconcurrent cohort study that included 464 case and 639 control women who had a Papanicolaou test was performed. Office workflow was redesigned using Toyota production system methods by introducing a 1-by-1 continuous flow process. We measured the frequency of Papanicolaou tests without a transformation zone component, follow-up and Bethesda System diagnostic frequency of atypical squamous cells of undetermined significance, and diagnostic error frequency. RESULTS: After the intervention, the percentage of Papanicolaou tests lacking a transformation zone component decreased from 9.9% to 4.7% (P = .001). The percentage of Papanicolaou tests with a diagnosis of atypical squamous cells of undetermined significance decreased from 7.8% to 3.9% (P = .007). The frequency of error per correlating cytologic-histologic specimen pair decreased from 9.52% to 7.84%. CONCLUSIONS: The introduction of the Toyota production system process resulted in improved Papanicolaou test quality.
OBJECTIVE: The objective of the study was to determine whether the Toyota production system process improves Papanicolaou test quality and patient safety. STUDY DESIGN: An 8-month nonconcurrent cohort study that included 464 case and 639 control women who had a Papanicolaou test was performed. Office workflow was redesigned using Toyota production system methods by introducing a 1-by-1 continuous flow process. We measured the frequency of Papanicolaou tests without a transformation zone component, follow-up and Bethesda System diagnostic frequency of atypical squamous cells of undetermined significance, and diagnostic error frequency. RESULTS: After the intervention, the percentage of Papanicolaou tests lacking a transformation zone component decreased from 9.9% to 4.7% (P = .001). The percentage of Papanicolaou tests with a diagnosis of atypical squamous cells of undetermined significance decreased from 7.8% to 3.9% (P = .007). The frequency of error per correlating cytologic-histologic specimen pair decreased from 9.52% to 7.84%. CONCLUSIONS: The introduction of the Toyota production system process resulted in improved Papanicolaou test quality.
Authors: Janneke E van Leijen-Zeelenberg; Arianne M J Elissen; Kerstin Grube; Arno J A van Raak; Hubertus J M Vrijhoef; Bernd Kremer; Dirk Ruwaard Journal: BMC Health Serv Res Date: 2016-01-19 Impact factor: 2.655
Authors: Giovanni Improta; Maria Romano; Maria Vincenza Di Cicco; Anna Ferraro; Anna Borrelli; Ciro Verdoliva; Maria Triassi; Mario Cesarelli Journal: BMC Health Serv Res Date: 2018-12-03 Impact factor: 2.655
Authors: Zeyad Mahmoud; Nathalie Angelé-Halgand; Kate Churruca; Louise A Ellis; Jeffrey Braithwaite Journal: BMC Health Serv Res Date: 2021-04-26 Impact factor: 2.655