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Researchers at Northwell Health Labs in New York used a five-stage method to develop and implement five process measures that improved turnaround time (TAT) significantly for three key analytes. The mean TAT improved for all three analytes—cardiac troponin T (cTn), potassium, and complete metabolic panel-albumin (CMP-Alb)—dropping in minutes from 52.04 to 42.63, 39.61 to 38.55, and 41.85 to 40.46,respectively. This team of clinical laboratory professionals reported on their efforts in the November issue of The Journal of Applied Laboratory Medicine (JALM).
As part of a 2-year quality improvement plan, the lab team used five steps to analyze how they could improve the lab’s workflow, including:
- Defining the situation or defect;
- Gathering close-by details;
- Looking outside the laboratory;
- Identifying the feasibility of proposed changes; and
- Making trial-by-error changes until metric outcomes approached the goal.
The study focused particularly on improving TAT for three analytes for tests processed at Long Island Jewish Hospital in Lake Success, New York.
During a 20-month process improvements initiative the laboratorians sought changes that would:
- Address waste in scanning specimens;
- Address waste in the lab’s layout;
- Address waste at peak hours of specimen processing;
- Address waste generally in the chemistry line; and
- Improve buy-in from all staff.
To achieve these objectives lab leaders implemented three preanalytic and two analytic changes. One preanalytic change involved identifying reasons for barcode failure or rejection. This led the team to change barcode symbology from code 39 to code 128.
The team also implemented a new lab layout, which prioritized cutting how far staff would have to walk to load specimens on the preanalytic system. In addition, they modified medical laboratory assistant schedules, and turned on autoverification for cTn results below the clinical threshold.
Read the November issue of JALM to learn more about how this team used process improvements to successfully reduced TAT.