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By Ken Bahk
10/09/07
‘Interdisciplinary’ Extends Beyond the Halls of Science
Ken Bahk
“Use best practices to improve efficacy and efficiency.” With
a cursory glance, this tenet appears unsophisticated and straightforward. In
our daily lives, however, such best practices often remain within specific
silos, hidden from other areas where they may provide added value. Learnings
and efficiencies within auto manufacturing tend to remain in auto manufacturing.
The same goes for learnings and efficiencies within laboratory medicine: They
tend to remain in the lab. Best laboratory practices at Hospital A are rarely
shared with Hospital B, which sits across the street. However, greater sharing
of ideas will result in improved performance. Sharing not only includes between
Hospital A and B, but also between the auto manufacturer and hospitals. A true
interdisciplinary mindset may enable marked improvement in our laboratories
and, in turn, capture greater efficiencies and improve patient care.
The National Institutes of Health embraced the interdisciplinary approach
years ago. It was identified that “the traditional divisions within health
research may, in some instances, impede the pace of scientific discovery.” Interdisciplinary
research across chemistry, molecular biology, pathology, and other specialties
was encouraged, and today the fruits of such collaborative efforts are exemplified
by advances in molecular biology and molecular imaging, to name a few. What
if we extend “interdisciplinary” beyond the halls of science?
Laboratory medicine, in simple terms, is the diagnostic application of science
that drives treatment and improves patient health. Our laboratories are aisles
of sophisticated instruments, skilled personnel, and massive infrastructure
(or space). Not to mention complicated information and billing systems. And
all parts must work seamlessly with each other. If we look to best
practices outside of laboratory medicine, if we look to business, we may learn
management, operational, and training strategies that herald significant improvements
in both efficiency and patient care. Two such leading best practices are LEAN
and the Bass Diffusion Model. LEAN is an example of interdisciplinary efforts
already in progress. The Bass Diffusion Model illustrates a more esoteric unknown
business concept that may be relevant to our community.
Rightfully so, LEAN appears to be en vogue in laboratory sciences with educational
efforts by professional societies such as the CLMA (www.clma.org) and American
Association for Clinical Chemistry (www.aacc.org). Originally developed by
Toyota, Lean manufacturing is a general process management approach to achieve
greater value and efficiencies. This approach focuses on continuous improvement
with the elimination of waste as critical to success. Results can manifest
in improvements in turnaround time, cost, quality, and overall efficacy of
existing staff. Concurrent with LEAN, laboratorians may often experience Six
Sigma (a similar management philosophy), as both philosophies and practices
are complementary and serve to magnify positive improvements in efficiency.
The Bass Diffusion Model has not yet been applied to laboratory medicine, but
offers an intriguing prospect to our community. Developed by Frank Bass, the
Bass Diffusion model describes the adoption of new products and technologies
by first-time buyers. As laboratorians, we experience the introduction of new
technologies and biomarkers on an annual, if not more frequent, basis. What
if we can more accurately predict when our physicians will reach critical mass
to demand specific types of technologies/testing? We will then be able to bring
in and provide this testing to meet demand with the benefits being obvious
to both laboratorians and patients. Such an application of the Bass Diffusion
Model has yet to be rigorously applied to laboratory medicine but academic
leaders are presently applying this dogma to similar problems, which may result
in significant effects for laboratory medicine.
What this article is not: This is not an article to explain LEAN
or characterize the Bass Diffusion model in comprehensive detail. Tomes exist
that do so, along with extensive training courses. What this article is: Remaining
in our respective silos, though necessary to keep laboratories running, will
hinder our progress in the long run and constrain the quality of care we provide.
Look beyond your colleagues down the hall, past laboratories at other institutions,
farther than hospitals in different parts of the country and the world, and
peer into other disciplines to extract techniques for you. Taking action with
this truly interdisciplinary approach will improve your own practices and,
in turn, improve the care we each provide to patients.
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