achieving optimal laboratory blood testing tat

Copyright 2010, All rights reserved

Achieving optimal laboratory testing

turn-around-time

for timely patient care decisions

Lenox Hill Hospital


There was a perception that results from

morning phlebotomy rounds were not

available by the time Clinicians rounded

on their patients.


Retrospective review of

April 2014 dataOnly 30% of draw results available by 8:00am

0%

5%

10%

15%

20%

25%

30%

35%

7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM > 12:00PM


Retrospective review of

April 2014 data (cont.)

• Period evaluated: April 1 to 30, 2014

• Order time: 100% before 12:00pm

• Blood collection time: 5:00am

• Samples: 10,316 tests ordered

• Samples received in the lab: 100% by

08:08am


Creating a team Goal

Over the next six months (by the end of

November, 2014) improve turn-around-

times (TAT) to allow of 5:00am

blood draws to be resulted by

clinical rounds

80

%8:00a

m


Understanding the process

(as of May 2014)

Pre-Pre-analytical Phase

Pre Analytical Phase

Analytical Phase

Phlebotomist sending blood at the

completion of each unit

Only one accessioner available when the

majority of blood specimens arrive (6-7am)

Additional accessioning responsibilities

Schedules of technologists did not

correspond to time of greatest need


Means for improvementP

re-P

re-a

naly

tical

• Increase awareness through daily huddles

• Realign shifts to match workflow

• Phlebotomist TAT sheets

• Pneumatic tube every 30 minutes

Pre

-ana

lytica

l

• Increase awareness through daily huddles


• iLearn for specimen labeling

An

aly

tica

l • Increased awareness through daily huddles


• Tracker board monitor for specimen TAT


Our Action Plans

Pre-pre-analytical Phase

Send bloods every 30 minutes and at

completion of each unit

Use paper “punch cards” to track TAT from

when the phlebotomist sends up specimen to

when they are accessioned

Shift the start time for drawing priority units

with two available phlebotomists


Our Action Plans (cont.)

Pre-Analytical Phase

Change shift schedule so two accessioners

during busiest morning hour (6-7) and three

available thereafter

iLearn for specimen labeling to reduce

specimen defects and accessioning delays

(available January 2015)


Our Action Plans (cont.)

Analytical Phase

Realign technologists’ schedules to

correlate with times of largest specimen influx

Tracker board for real-time TAT data

(available December 2014)


SUMMARY OF SHIFT CHANGES


30%

37%

45%

65%

77%77%75%82%

62%59%61%

76%77%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

8:00 AM

Hematology morning workflow

adjustments

Tests Completed by 8:00am

Scheduling changes took effect


LESSONS LEARNED

Schedules are a powerful resource

Asking for and listening to employee input

and recognizing employees for their

achievements creates buy in and

contributes toward team success

Staff is willing to make changes that

improve patient care


Thanks to all Lenox hill Hospital

staff, Supervisors, Managers and Administration this

achievement

Your thoughts or

questions?

achieving optimal laboratory blood testing tat

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