Hospital - Phlebotomy
The results obtained such as reduced TAT and streamlined processes have permitted the Laboratory to further efficiently meet the demands and expectations of its customers.
Phlebotomy
When Lean Healthcare Inc. met with a recent Hospital team we introduced them to the Value Stream perspective. The Enterprise Value Stream perspective identified that there were a number of different functions that contributed to the ultimate outcome; getting the result to the customer.
In particular, the Enterprise Value Stream Map ™ captured the work of the Phlebotomist from collection at bedside or in the clinic, to Lab Receiving, Test Prep, and Testing to Resulting. Clearly, all of the staff in these areas, throughout the hospital, was working hard, yet the results did not reflect this effort. As in most organizations, this inconsistency in meeting the needed requirements of the various clients, often lead to finger pointing rather than a collective effort to problem solve and improve the end-to-end process.
Lean Healthcare Inc. worked with the phlebotomy team to create a visual representation, our Current State Map of the end to end flow of work from the patient to the final result back to the physician. We then applied the fundamental principles of Lean, Flow and Pull to create a vision. This became our Future State Value Stream Map. This helped to identify what we needed to do to close the gap between the Current State and the Future State. This list of things to do became our Implementation Plan. It identified all of our Kaizens and the sequence in which those kaizens should be completed. A Kaizen is a focused burst of energy and effort by an implementation team to achieve a specific result. We then assisted the team to implement the Plan and improve the flow of work in order to close the gap from our Current to our Future state.
A specific Kaizen involved a large team of Phlebotomists at the hospital responsible for collection at bedside and the hospital outpatient clinic. The Kaizen team examined how the collections were currently being done. They brainstormed and came up with ideas based on Lean Principles that improved their completion times for am (morning) collections.
The phlebotomy team identified a number of examples of Motion and Travel Waste that contributed to the delays in completing their draws. As a result of their efforts, a new collection system was introduced. Results of the changes were immediately noticed by the staff in all departments. The chart below identifies a 38% improvement in collections within the first two weeks while volumes actually increased. This allowed for better turnaround time more predictability in the end-to-end process from collection at bedside or in the clinic, to Lab Receiving, Test Prep, and Testing to Resulting.
This kaizen in conjunction with others within the end-to-end Value Stream contributed to an overall improvement in Turnaround time (TAT) from Collect through to Result. The team was now focused on looking horizontally along the Value Stream. The entire group was working together as one unit. They were focused on how each process could support one another rather than simply focusing on optimizing their own function.