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    Utilisation of LEAN Start Up methodology for the identification, development, and pilot of novel services that red cell immunohaematology can provide hospital transfusion laboratories

    Hazell, Matthew J (2023) Utilisation of LEAN Start Up methodology for the identification, development, and pilot of novel services that red cell immunohaematology can provide hospital transfusion laboratories. Doctoral thesis (DClinSci), Manchester Metropolitan University.

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    Abstract

    Introduction Service development is improved by customer input. LEAN Startup streamlines collective idea creation in extreme uncertainty, providing collaboration to match a service to customer wants. Uncertainty brought by pathology networks prompted Red Cell Immunohaematology (RCI) to use LEAN Startup to develop services beyond its traditional testing role with the Bristol Royal Infirmary (BRI). Methods The Value Proposition Canvas (VPC) Customer Profile, Kano model and the Business Model Canvas (BMC) identified themes and attributes for new service provision. The VPC Customer Profile identified the BRIs jobs, pains, and gains. Process mapping gathered data relating to: (i) ISO15189 vertical audit training and completion; (ii) Sample verification, automation, and manual crossmatch processes. Online Miro based events allowed redesign of processes. Results Three themes were identified (i) Quality assurance – Enables a self-sufficient laboratory, provides centralised document control, facilitates compliance; (ii) LEAN Laboratory – Part of daily practice, (iii) Training – Demonstrates effectiveness of a cross-organisational platform for competency. The VPC Value Map and BMC resulted with the Laboratory Solution Development Platform to support hospital partner service provision. The Build-Measure-Learn cycle resulted in three options: (1) The hospital partner bespoke service; (2) The hospital and RCI full partnership bespoke service (3) RCI led generic template service. Option 2 targeted two job themes: (i) Vertical audit training and completion to meet ISO15189 accreditation requirement. New training material was created. A new audit process allowed planning, process observation and report generation; (ii) Improve process flow. The laboratory layout was sub-optimal. A new layout reduced process waste, improved patient safety and blood readiness. Conclusion LEAN Startup principles and related business tools allowed identification, development, and pilot of a service beyond RCIs traditional testing role. Benefits were related to: A better understanding of the current market; An improved relationship between RCI and hospital; Empowerment of the HTL; improved patient safety and treatment times.

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