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Am J Obstet Gynecol. 2006 Jan;194(1):57-64.

Improving Papanicolaou test quality and reducing medical errors by using Toyota production system methods.

Author information

1
Department of Pathology, School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15232, USA. raabss@upmc.edu

Abstract

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.

PMID:
16389010
DOI:
10.1016/j.ajog.2005.06.069
[Indexed for MEDLINE]

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