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The Henry Ford Production System
Effective Reduction of Process Defects and Waste in Surgical Pathology

Richard J. Zarbo MD, DMD, Rita D’Angelo MS, ASQ CQE, SSBB
DOI: http://dx.doi.org/10.1309/RGF6JD1NAP2DU88Q 1015-1022 First published online: 1 December 2007


By adopting a cultural transformation in its employees’approach to work and using manufacturing-based continuous quality improvement methods, the surgical pathology division of Henry Ford Hospital, Detroit, MI, focused on reducing commonly encountered defects and waste in processes throughout the testing cycle. At inception, the baseline in-process defect rate was measured at nearly 1 in 3 cases (27.9%). After the year-long efforts of 77 workers implementing more than 100 process improvements, the number of cases with defects was reduced by 55% to 1 in 8 cases (12.5%), with a statistically significant reduction in the overall distribution of defects (P = .0004). Comparison with defects encountered in the preimprovement period showed statistically significant reductions in preanalytic (P = .0007) and analytic (P = .0002) test phase processes in the postimprovement period that included specimen receipt, specimen accessioning, grossing, histology slides, and slide recuts. We share the key improvements implemented that were responsible for the overall success in reducing waste and rework in the broad spectrum of surgical pathology processes.

Key Words:
  • Quality improvement
  • Lean
  • Henry Ford
  • Toyota
  • Surgical pathology