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

Purpose – Clinical 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/approach – The 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. Findings – The 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/value – This 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.