Thursday, April 28, 2005

Improvement of STAT Results Turn Around Time – A Six Sigma Approach

F. Leland McClure, Quest Diagnostics, Inc, 2040 Concourse Drive, St. Louis, MO, USA

4.5% of the time STAT test turnaround time was not meeting the customer requirement of 2 to 3 hours. Though the defect rate was low, in the interest of the patient care, it was decided to further reduce the defect rate of not meeting turnaround time.

Improve STAT turnaround time.

Design: Six Sigma methodology
Setting: Clinical regional reference laboratory
Participants: Multiple Core business processes - Collect the Specimen, Transport the Specimen, Process the Specimen, Test the Specimen and Report Results.
Interventions: Developed Step-by-step process maps, workflow diagrams and analyzed data to understand process flow and cycle times of various steps. Several root causes were identified including lack of single standard for handling priority specimens, lack of cycle time measures for key steps, lack of an actionable LIS (Laboratory Information System) report on overall STAT turnaround time and lack of process ownership.
Based on the failure mode analysis; 1) Reduced unnecessary hand-offs, 2) Developed visual tools to proactively monitor and track STAT test requests including new STAT turnaround time reports and 3) Developed training for staff as well as assigned clear process ownership.

Logistical delays reduced by 53%; specimen processing delays reduced by 100%. Overall STAT turnaround time delays (time of specimen pickup call to results delivery) reduced from 4.5% to 2.2%.

Service cycle time is as important as the quality of the result itself due to impact on patient care. Cycle time defects, even if low, are unacceptable in a high volume clinical testing lab operation. The Six Sigma methodology is an effective tool to reduce both defects and variation in service delivery especially when the defects are ‘low' to begin with and eliminate root causes.

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See more of The 2005 Institute for Quality in Laboratory Medicine Conference