Hospital - Core Laboratory
By focusing on improved flow, labs have discovered that they have eliminated waste in their processes with a significant positive impact on cost. Reported numbers show a 25-30% reduction in labor cost per test.
Core Laboratory
Healthcare organizations are faced with a very real dilemma of rising costs and the need to provide healthcare services to an ever demanding, ever growing population. Many initiatives have been undertaken over the last number of years with good intention but relatively limited success. Healthcare organizations are asking how Lean can work for them.
Initial Lean applications at most hospitals have started within a Lab environment. Although Lean has a place in any organization and type of environment, Labs have been seen as a good area to start. Is this because Labs are where the most waste - absolutely not! Healthcare administrators simply see Lab processes as those that most resemble manufacturing type processes.
When Lean Healthcare Inc. met with a recent Core Lab team, we introduced them to the Value Stream perspective. It became clear that they were a Core Lab in name only. Organization and setup was still based on traditional, functional, silo thinking - Chemistry lab, Hematology lab, Coag lab etc. The Value Stream perspective drove a new way of organizing the Lab that truly broke down the silos and integrated the work to better reflect what the customer needed. This created a fully functioning and responsive Core Lab.
Lead time or Turnaround Time (TAT) in a lab is often the most critical measure of success. However, when looking at this performance metric, it is usually in isolation by test type. However, our customer / client, the treating physician often is ordering a series of tests and it is usually the result from the series of tests ordered that directs the treatment plan. Therefore excellent TAT for one test may be offset by poor performance with another. Therefore, Labs must look at the family of tests that they perform and improvement must be made system wide.
Another critical issue is the variation or the inconsistency in reporting. This performance variation lowered the confidence level of the provider many compensated by ordering Stat tests when they should really be routines. This simply exaggerated and amplified the problems. Once we have established the family of tests, we work with our lab teams to develop an end-to-end Current State Enterprise Value Stream Map ™.
We then apply the fundamental principles of Lean to create a vision, a Future State Value Stream Map.
We then help the team to implement a Plan and improve the flow of work in order to close the gap from our Current to our Future state.
Results for the Core Labs that Lean Healthcare Inc. has worked with have consistently provided similar improvements. Specifically, we see an improvement in TAT time and a convergence of the results of one test compared to another. Our work with teams moves them from a stress filled environment where everyone is rushing around and firefighting to an established and consistent pace of work. By focusing on improved flow, labs have discovered that they have eliminated waste in their processes with a significant positive impact on cost. Reported numbers show a 25-30% reduction in labor cost per test.
Lean allowed the Core Lab to improve seemingly competing Key Performance Indicators:
- Service - Improved Turnaround Time
- Quality - Eliminate of test outliers
- Cost - Reduced labor cost per test
- Culture - Sense of Pride and Less Stress