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

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.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Raab SS,Andrew-Jaja C,Condel JL,Dabbs DJ

doi

10.1016/j.ajog.2005.06.069

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

57-64

issue

1

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(05)00972-5

journal_volume

194

pub_type

杂志文章

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