Where high-volume value streams exist with irregular or indeterminate arrival or demand patterns (such as health care laboratories often see), the answer is to look for ways to reduce the batch size to the optimal point so that work can flow whenever possible. When flow ceases, the work can be managed and controlled in smaller batches. Smaller batches mean faster turnaround times, which in turn relates to faster throughput and higher levels of productivity for the organization. As you can see in Figure 17.4, cutting the batch size in half reduces the time it takes to get the first unit of work out the door by 33.3%. If this is the best that can be achieved, take advantage of it. Put it on the Future State Map and move forward. For seldom-used, on-demand-type value streams that operate almost randomly in a low-volume setting, there is little chance for creating continuous flow. Because many of these low-volume value streams are operated by a single person from start to finish, it is also impossible to use the concept of one-piece flow as it is used in high-volume production settings. But not being able to use the concepts as presented in high-volume production environments does not mean you cannot create flow. It merely means that the way you set up the future state may require thinking outside the box. If the current-state batches work throughout the process in an attempt to “take advantage of employees’ time,” there are simple ways to create flow—not continuous, but at least synchronous. In these low-volume indeterminate-demand processes, as the work appears, each unit of work should be processed as far through the value stream as possible