During the study period, a total of 234 616 Pap tests were processed and evaluated, 108 828 (mean [SD] = 6801 /mo) and 125 788 (6620 /mo) before and after FPGS and lean principles implementation, respectively.
Before FPGS and lean principles implementation, the mean total cycle time was 158.
The Table summarizes the overall TAT before and after FPGS and lean principles implementation.
For the first 19 months after FPGS implementation, the average false-negative fraction was 0.
Although the average monthly volume of Pap test specimens after FPGS implementation was lower than it was before FPGS implementation, the decrease in the monthly volume was equivalent to less than a 3-day workload of a cytotechnologist, assuming the average daily cytotechnologist volume of 65 slides before FPGS implementation.
8 minutes; with FPGS, the equivalent time was reduced by 17% to 5.
Although the reduction in the screening time was substantial, the implementation of FPGS alone cannot explain the dramatic improvement in the overall TAT.
Using value-stream mapping, we discovered that more than 90% of the cycle time was nonvalue-added time before FPGS and lean principles implementation.
The implementation of FPGS and lean principles made it possible for the laboratory to reduce the number of cytotechnologist positions from 15 to 13 (a 13% reduction); one employee left before FPGS implementation and another left 3 months after FPGS implementation.