Enhancing waiting time performance of clinical laboratories for pregnant patients with seasonal respiratory diseases: a simulation-based Lean Six Sigma approach

Miguel Ortíz-Barrios, Helder Jose Celani de Souza, Antonella Petrillo, Muhammet Gul, Melih Yücesan, Eduardo Navarro-Jiménez, Juan-José Alfaro-Saíz and Andrés Ariza-Ortíz

International Journal of Productivity and Performance Management, 2026, vol. 75, issue 9, 2969-2996

Abstract: PurposeClinical laboratory performance is critical in managing seasonal respiratory diseases (SRDs); however, prolonged waiting times can lead to patient dissatisfaction and nonquality costs. This challenge is particularly acute for pregnant patients, who face increased health risks from diagnostic delays. This study aims to improve waiting times before sample collection in clinical laboratories serving pregnant patients with SRDs by integrating Lean Six Sigma (LSS) and Discrete-Event Simulation (DES).Design/methodology/approachThe proposed framework was validated in a public clinical laboratory using the DMAIC (Define–Measure–Analyze–Improve–Control) methodology. DES was embedded within the Analyze and Improve phases to model patient flow and assess improvement scenarios before implementation.FindingsThe integrated LSS–DES approach resulted in a significant reduction in waiting times. During SRD peak periods, waiting time before sample collection for pregnant patients decreased from 1.01 to 0.10 h per patient. These results demonstrate the framework's effectiveness and practical usefulness for decision-makers seeking performance improvements in resource-constrained healthcare environments.Originality/valueThis study enhances existing literature by integrating LSS and DES to address laboratory performance challenges associated with SRDs. The combined LSS-DES used for pregnant patients during outbreak periods is novel. The study offers contextual innovation for a vulnerable population, methodological advancement through embedding DES within the DMAIC cycle, and practical laboratory validation. The framework is particularly valuable for low- and middle-income countries (LMICs), where scalable solutions are essential.

Keywords: Performance management; Lean Six Sigma (LSS); Discrete-event simulation (DES); Clinical laboratories; Seasonal respiratory diseases (SRDs); Pregnancy (search for similar items in EconPapers)
Date: 2026
References: Add references at CitEc
Citations:

Downloads: (external link)
https://www.emerald.com/ijppm/article/75/9/2969/13 ... formance-of-clinical (text/html)
https://www.emerald.com/ijppm/article-pdf/75/9/296 ... m-03-2025-0187en.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eme:ijppmp:ijppm-03-2025-0187

DOI: 10.1108/IJPPM-03-2025-0187

Access Statistics for this article

International Journal of Productivity and Performance Management is currently edited by Dr Aylin Ates and Dr Berk Kucukaltan

More articles in International Journal of Productivity and Performance Management from Emerald Group Publishing Limited
Bibliographic data for series maintained by Emerald Support ().