1. “Lean Thinking” (or simply "Lean") is a production philosophy that aims to reduce the interval between the client request and product delivery to customer. The Lean Thinking aims to accelerate the production process through the elimination of activities in process that does not add value to the customer. The Six Sigma approach aims to reduce the processes variation, suggesting the existence of a direct correlation between the number of products with defects, percentage of revenues wasted with these defects and the level of customer satisfaction with the offered product or service. A Six Sigma process produces no more than 3.4 defects per million opportunities, where defect is defined as any feature of the product or service outside the specifications desired by the customer. The adequate implementation of the "Lean" and "Six Sigma" in an organization can result in competitive advantage, providing control and continuous and robust improvement in processes performance, adding more value to the product or service offered to customers, with significant results for the company. However, the effective incorporation of these methodologies in the quality culture of companies is generally not simple or quick, and should be implemented using gradual approach. The purpose of this study was to evaluate the incorporation of "Lean" and "Six Sigma" in our laboratory, using as example improvement initiatives for hCG (Human Chorionic Gonadotropin assay) process. In 2003, we implemented a first improvement initiative for "hCG" process, using “Lean” principles. This initiative was focused on eliminating the activities that does not add value to the patient, flow optimization and speed up the process. In 2005, with a more structured Six Sigma program in the lab, a new improvement project for the "hCG" process was performed using systematic approach, oriented by the DMAIC methodology (Define-Measure-Analyze-Improve-Control roadmap), focusing on robust and effective process control. Before the first project in the hCG process, the average process cycle time was 170 minutes (min.), with standard deviation (SD) of 70 min. In 2003, after “Lean” intervention, the average time dropped to 121 min. (SD = 35,7). After DMAIC project, the average process cycle time was 72,2 min. (SD = 16,3). This second intervention in the process enabled, with a high degree of compliance (5,01 sigma), to attend a new proposed target specification of turnaround time for hCG process (2 hours). This improved process was released in 2006 to our customers as a new and differentiated service (“urgent hCG”), with a positive impact on customers satisfaction (95,6% to 97,1%) and a significant return of investment for the organization (increase of 37% in number of hCG assays performed 1 year after the end of second project). The challenges and results of developed projects for hCG process improvement contributed decisively to the incorporation of “Lean” and “Six Sigma” philosophies in the quality culture of laboratory. This implementation strategy through sequential process improvement initiatives and with increasing degree of systematization showed to be an effective strategy for incorporation of these philosophies in organization´s quality culture, contributing to obtain effective and sustainable results. BERLITZ, F. Weinmann Laboratório - Porto Alegre, Brazil fberlitz@weinmann.com.br LEAN AND SIX SIGMA IMPLEMENTATION IN A CLINICAL LABORATORY: A REAL STORY ABSTRACT Poster Code: A-82 Session: 04 -Management “Lean Thinking” (or simply "Lean") is a production philosophy that aims to reduce the interval between the client request and product delivery to customer. The Lean Thinking aims to accelerate the production process through the elimination of activities in process that does not add value to the customer. The Six Sigma approach aims to reduce the processes variation, suggesting the existence of a direct correlation between the number of products with defects, percentage of revenues wasted with these defects and the level of customer satisfaction with the offered product or service. A Six Sigma process produces no more than 3.4 defects per million opportunities, where defect is defined as any feature of the product or service outside the specifications desired by the customer. The adequate implementation of the "Lean" and "Six Sigma" in an organization can result in competitive advantage, providing control and continuous and robust improvement in processes performance, adding more value to the product or service offered to customers, with significant results for the company. However, the effective incorporation of these methodologies in the quality culture of companies is generally not simple or quick, and should be implemented using gradual approach. INTRODUCTION The purpose of this study was to evaluate the incorporation of "Lean" and "Six Sigma" in our laboratory, using as example improvement initiatives for hCG (Human Chorionic Gonadotropin assay) process. OBJECTIVES In 2003, we implemented a first improvement initiative for "hCG" process, using “Lean” principles. This initiative was focused on eliminating the activities that does not add value to the patient, flow optimization and speed up the process. In 2005, with a more structured Six Sigma program in the lab, a new improvement project for the "hCG" process was performed using systematic approach, oriented by the DMAIC methodology (Define-Measure-Analyze-Improve-Control roadmap), focusing on robust and effective process control. METHODS AND PROCEDURES RESULTS CONCLUSIONS The challenges and results of developed projects for hCG process improvement contributed decisively to the incorporation of “Lean” and “Six Sigma” philosophies in the quality culture of laboratory. This implementation strategy through sequential process improvement initiatives and with increasing degree of systematization showed to be an effective strategy for incorporation of these philosophies in organization´s quality culture, contributing to obtain effective and sustainable results. Before the first project in the hCG process, the average process cycle time was 170 minutes (min.), with standard deviation (SD) of 70 min. In 2003, after “Lean” intervention, the average time dropped to 121 min. (SD = 35,7). After DMAIC project, the average process cycle time was 72,2 min. (SD = 16,3). This second intervention in the process enabled, with a high degree of compliance (5,01 sigma), to attend a new proposed target specification of turnaround time for hCG process (2 hours). This improved process was released in 2006 to our customers as a new and differentiated service (“urgent hCG”), with a positive impact on customers satisfaction (95,6% to 97,1%) and a significant return of investment for the organization (increase of 37% in number of hCG assays performed 1 year after the end of second project).