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9. Lean Laboratory and Continuous Improvement Concepts within Laboratory Informatics
9.精益实验室和实验室信息学内的持续改进概念
9.1 Lean Laboratory---Laboratory informatics can be used to support and facilitate lean concept implementation, resulting in significant benefits when they are integrated successfully. Lean concepts can be applied in laboratories to improve productivity, quality, and efficiency while reducing costs. Lean concepts most likely to be facilitated with laboratory informatics include workload leveling and flow, visual management, continuous process improvement, and waste reduction. Each of these concepts is briefly described below.
9.1精益实验室--实验室信息学可以用来支持和促进精益概念的实施,当它们成功整合时,会带来显著的益处。精益概念可以应用于实验室,在降低成本的同时提高生产力、质量和效率。实验室信息学最有可能促进的精益概念包括工作量平衡和流程化、可视化管理、持续过程改进和减少废物。这些概念中的每一个简要描述如下。
9.2 Workload Leveling and Flow--Leveling strategies are used to balance the incoming workload and maintain a consistent workflow to make the best use of the resources available in the laboratory. Leveling is the smoothing of the variability of the incoming demand for work by ensuring that each work day has a consistent workload. Continuous flow concepts keep the work moving through the laboratory processes while minimiz
ing queuing or backlog between steps. (Examples of areas in which workload leveling and flow can be applied include functions C-1, C-2, C-3, C-4, C-5, and E-14 of the laboratory informatics functions map in Fig. 3.)
9.2工作量平衡和流程化---平衡策略用于平衡传入的工作负荷,并保持一致的工作流程,以最佳利用实验室可用的资源。平衡是通过确保每个工作日都有一致的工作量来平滑传入的工作需求的可变性。连续流概念使工作在实验室过程中不断发展,同时尽量减少步骤之间的排队或积压。(可以应用工作量平衡和流程化的领域示例包括图3中实验室信息学功能图的功能C-1、C-2、C-3、C-4、C-5和E-14。)
9.2.1 Laboratory informatics systems contain the data needed to develop workload leveling and flow strategies. This includes expected average incoming workload demand, expected turn-around times for sample testing, actual testing times, optimal testing batch sizes, required sample result due dates by customer, current amount of work in the laboratory, and available staff and equipment.
9.2.1实验室信息学系统包含制定工作量平衡和流程化策略所需的数据。这包括预期的平均进料工作量需求、样本检测的预期周转时间、实际检测时间、最佳检测批量、客户要求的样本结果截止日期、实验室的当前工作量以及可用的工作人员和设备。
9.2.2 Laboratory informatics can be used to automate the release of work into the laboratory based on the workload leveling strategy for each laboratory, thereby minimizing the scheduling and planning effort required to level the daily workload.
9.2.2实验室信息学可用于根据每个实验室的工作量平衡策略,将工作自动释放到实验室中,从而最大限度地减少日常工作量水平所需的调度和规划工作。
9.3 Visual Management---Visual management implementaton allows quick assessment of workflow processes at strategic points and is meant to provide the opportunity to indicate whether a process is working optimally. (Examples of areas where visual management can be applied include functions C-3, C-4, and many of the E functions of the laboratory informatics functions map in Fig. 3.) Laboratory informatics can support this Mean concept by visually displaying summarized data and compiling all needed information into one location to allow all users to identify quickly workload requirements as well as where review and action is required. Laboratory workflows can also be visually displayed by laboratory informatics systems, showing sample queues, sample locations, test status, samples/tests ready for review, and areas that need attention (that is, laboratory investigations).
9.3可视化管理--可视化管理实现允许在战略点快速评估工作流过程,并旨在提供显示流程是否最佳化的机会。(可应用视觉管理的领域示例包括图中实验室信息学功能图3的功能C-3、C-4和许多E功能。)实验室信息学可以通过直观显示汇总数据并将所有需要的信息编译到一个位置来支持这一Mean概念,允许所有用户快速识别工作量要求以及需要审查和行动的地方。实验室信息学系统还可以直观地显示实验室工作流程,显示样本队列、样本位置、检测状态、准备用于审核的样本/检测以及需要注意的区域(即实验室调查)。
9.3.1 Color coding, symbols, and icons that are easily understood and recognizable can be used to allow users to understand statuses and identify issues quickly. For example, dashboards can have colored gauges to represent the percent of work completed on-time, the current turnaround time against a six-month average, or the amount of scheduled work as a percentage of capacity.
9.3.1易于理解和识别的颜色编码、符号和图标可用于允许用户快速理解状态和识别问题。例如,仪表板可以有彩色来表示按时完成的工作百分比、当前周转时间与6个月平均值的比值或计划的工作量占容量的百分比。
9.3.2 Visual management dashboards can be used to provide real time electronic updates on sample status for customers of the laboratory.
9.3.2可视化管理仪表板可用于为实验室客户提供样品状态的实时电子更新。
9.3.3 Other examples include real time-control charts showing key performance indicators versus their warning and control limits, graphs of error rates pinpointing areas of opportunity for improvement, pop-up alerts indicating imminent deadlines, and so forth.
9.3.3其他示例包括显示关键性能指标及其警告和控制限度的实时控制图、精确定位改进机会区域的错误率图、指示即将截止日期的弹出警报等。
9.4 Continuous Process Improvement---Continuous process improvement tools are used to map actual workflow and can help identify potential failure points or places where consolidation or separation of steps would be beneficial. (Examples of areas where continuous process improvement can be applied include many functions but in particular C-3, E-5, and E-13 of the laboratory informatics functions map in Fig. 3.) A key to success with continuous process improvement is to understand the workflow and identify waste at the ground level of laboratory processes, with subsequent implementation of small changes continuously rather than major changes all at once. Laboratory informatics can support this by rendering data onto dashboards and reports and into control charts and production graphs, including data such as error rates, turnaround times, inventory control, and so forth. These can be used to identify bottlenecks and vulnerable steps in the processes and also to monitor the effectiveness of improvements. The data in the laboratory informatics systems can be used to measure and monitor key performance indicators before and after implementation of changes, as well as inform future decisions.
9.4持续流程改进--持续流程改进工具用于绘制实际工作流程,可以帮助确定潜在的故障点或,确定步骤合并或分离将是有益的地方。(可应用持续流程改进的领域示例包括许多功能但特别是图3中实验室信息学功能图的C-3、E-5和E-13。)持续流程改进成功的一个关键是了解工作流程,在实验室流程的基础层面识别浪费,随后连续实施微小变更,而不是一次性实施重大变更。实验室信息学可以通过将数据呈现在仪表板和报告上,并呈现在控制图和生产图中来支持这一点,包括错误率、周转时间、库存控制等数据。这些可以用来确定进程中的瓶颈和脆弱步骤,并监测改进的有效性。实验室信息学系统中的数据可用于测量和监测实施变更前后的关键性能指标,以及为未来的决策提供信息。
9.5 Waste Reduction---Waste reduction as a concept covers many areas, all related by the goal to decrease the amount of effort or time that does not add value to the product from the customer's point of view. Continuous process improvement can be used to reduce waste in laboratory processes. Some key opportunities for waste reduction within laboratories are planning and scheduling work, reviewing and approving data, filing paperwork, documenting, and entering or transcribing data. The following are examples of waste reduction strategies that can result in significant benefits for a laboratory:
9.5减少浪费--减少浪费作为一个概念涵盖了许多领域,所有这些领域都与减少从客户的角度来看不会增加产品价值的工作量或时间的目标有关。可采用持续工艺改进来减少实验室工艺中的浪费。实验室内减少浪费的一些关键机会是计划和安排工作、审查和批准数据、归档文书、记录以及输入或转录数据。以下是可为实验室带来显著益处的废物减少策略示例:
9.5.1 Review by exception is a waste reduction strategy that uses laboratory informatics systems to monitor key process parameters of mature, highly repeatable batch processes, and to evaluate them against specifications that have been configured and validated within the laboratory informatics system. Visual management tools such as color coding or symbols allow out-of-specification results identified by the laboratory informatics system to be flagged for laboratory analyst/supervisor review, while in-specification results are confirmed by the system and do not proceed to a manual review. (Examples of areas where review by exception can be applied include functions C-4 and E-9 of the laboratory informatics functions map in Fig. 3.) Examples of laboratory transactions that can use review by exception concepts include fit for use of equipment, raw materials, and consumables; training records; deviations from standard operating procedures; and so forth. Evaluation of only the failing parameters reduces the time spent reviewing and approving, resulting in a faster time to release, lower cost, and higher throughput.
9.5.1例外情况审查是一种减少浪费的策略,使用实验室信息学系统来监测成熟的、高度可重复的批处理工艺的关键工艺参数,并根据实验室信息学系统内配置和验证的质量标准对其进行评价。可视化管理工具(如颜色编码或符号)允许标记实验室信息学系统识别的超出质量标准的结果,以供实验室分析员/主管审查,而符合质量标准的结果由系统确认,不进行手动审查。(可以应用异常审查的领域示例包括图3中实验室信息学功能图的功能C-4和E-9。)可通过例外情况概念进行审查的实验室活动示例包括适合使用设备、原材料和耗材;培训记录;偏离标准操作规程等。仅对失败的参数进行评估会减少审查和批准所花费的时间,从而缩短放行时间、降低成本并提高吞吐量。
9.5.2 Automation is another waste reduction approach to reduce time spent on processes in which there are set formulae, rules, or steps by using the laboratory informatics system to perform these types of transactions instead of a laboratory analyst. (Examples of areas where automation can be applied include functions E-6 and C-6 of the laboratory informatics functions map in Fig. 3.) Examples of these processes within laboratory informatics include calculations; batching of samples; parsing of data from instruments, spreadsheets, and tracking systems; passing or sharing of information from one system to another; and data compilation. Automation of these processes removes the need for the secondary manual review of accuracy, allowing for more productive work to occur.
9.5.2自动化是另一种减少浪费的方法,通过使用实验室信息学系统而不是实验室分析员来执行这些类型的活动,以减少在设定公式、规则或步骤的过程上花费的时间。(可以应用自动化的领域示例包括图3中实验室信息学功能图的功能E-6和C-6。)实验室信息学中这些过程的示例包括计算;样本批处理;解析仪器、电子表格和跟踪系统的数据;将信息从一个系统传递或共享到另一个系统;以及数据汇编。这些过程的自动化消除了对准确性进行二次手动审查的需要,允许进行更有效的工作。
9.5.3 Paperless laboratory processes are waste reduction tactics to reduce the amount of activities executed on paper. Paper-based transactions can be error prone and require manual reviews to confirm accuracy, are difficult to search for data and information when there are investigations, and require physical handoffs that can increase wait times in laboratory processes. In addition, the paper itself creates wasteful nonvalue-added
tasks, as paper shall be purchased, handled, filed, stored, and destroyed. (Examples of areas where paperless processes can be applied include functions E-1, E-6, E-8, and E-13 of the laboratory informatics functions map in Fig. 3.)
9.5.3无纸实验室流程是减少浪费的策略,以减少纸质文件上执行的活动数量。纸质交易可能容易出错,需要人工审查来确认准确性,有调查时很难搜索数据和信息,需要物理交接,可以增加实验室过程的等待时间。此外,纸张本身会产生浪费性的非增值任务,因为纸张应被购买、处理、存档、储存和销毁。(可应用无纸化过程的区域示例包括图3中实验室信息学功能图的功能E-1、E-6、E-8和E-13。)
Paperless laboratory processes have a high potential of reducing nonvalue-added steps, a key factor in implementing lean. Laboratory informatics is a critical component of paperless laboratory processes, as its associated systems are able to display, store, and transmit information electronically. Laboratry informatics systems are also highly searchable electronic storage systems that allow for rapid retrieval of stored items, or
links to files stored in the informatics system. Going paperless with laboratory informatics includes activities like capturing data directly from a balance, pH meter, or other instrument; linking between systems to allow the sharing of one document without having it stored a second time; and covering the implementation of capturing logbook or notebook entries when a touchscreen or keyboard is used instead of a pen.
无纸实验室过程具有很高的潜力来减少非增值步骤,这是实施精益的关键因素。实验室信息学是无纸化实验室过程的关键组成部分,因为其相关系统能够以电子方式显示、存储和传输信息。实验室信息学系统也是高度可搜索的电子存储系统,允许快速检索存储的项目,或链接到存储在信息学系统中的文件。对实验室信息学进行无纸化处理包括直接从天平、pH计或其他仪器中获取数据;在系统之间建立链接,允许共享一份文件而无需二次存储;并涵盖使用触摸屏或键盘代替笔时捕获日志或笔记本条目的实现。
9.5.4 Mobile devices such as smartphones and tablet PCs that are able to receive notifications from an informatics system regarding imminent or actual issues or that are able to access inventory applications, dashboards, reports, and so forth, also support the lean concept of waste reduction. (Examples of areas where mobile devices can be applied include functions E-5, E-7, E-8, and E-10 of the laboratory informatics functions map in Fig. 3) With such easily accessed information available, decisions regarding remedial or corrective action can be made in a timely fashion, resulting in a quicker resolution of issues, faster turnaround, and greater productivity.
9.5.4移动设备,如智能手机和平板电脑,能够从信息学系统收到关于即将发生或实际问题的通知,或者能够访问库存应用程序、仪表板、报告等,也支持减少浪费的精益概念。(可应用移动设备的领域示例包括图3中实验室信息学功能图的功能E-5、E-7、E-8和E-10。)有了这样容易获得的信息,就可以及时做出关于补救或纠正行动的决定,从而更快地解决问题,更快地周转,提高生产力。
9.5.5 Streamlining laboratory informatics support functions is important to both the initial implementation as well as keeping support costs low. Examples include use of leveling, flow and standard work, and visual management concepts for administrative and support functions like master data maintenance, help desk support calls, change control monitoring, and user account maintenance.
9.5.5精简实验室信息学支持功能对于初始实施和保持支持成本较低都很重要。示例包括使用平衡、流程化和标准工作,以及管理和支持功能的可视化管理概念,如主数据维护、帮助台支持呼叫、变更控制监测和用户帐户维护。
9.5.6 Laboratory informatics can support the implementation of lean concepts in many ways. Informatics systems contain the data needed to summarize and evaluate performance markers and processes. They are responsible for handling the import and export of data, and for the controlled access to those data. Laboratory informatics systems are key elements in the improvement of productivity and efficiency, as well as the reduction of time and effort spent processing laboratory work, decision-making, and improving laboratory performance.
9.5.6实验室信息学可以在许多方面支持精益概念的实施。信息学系统包含总结和评价性能标记和过程所需的数据。他们负责处理数据的导入和导出,以及对这些数据的受控访问。实验室信息学系统是提高生产力和效率,以及减少处理实验室工作、决策和提高实验室性能所花费的时间和精力的关键要素。
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