MidlandMemorialHospitalusesLeantospeedtestingasmuchas42%,freesup5FTEsand775sq.ft.offloorspace
Caughtbetweenagrowingworkloadandchronicunderstaffing,thelaboratoryatMidlandMemorialHospitalaskedValuMetrix®ServicestoguideitthroughaLeaninitiative.Nowthelabisprovidingsignificantlyfasterservice–withasmallerstaff.
Aroundthattime,aqualityassurancecoordinatorreturnedfromaconferenceandrecommendedaLeaninitiative.“WelookedattwoservicesthatwouldprovideLeanconsultationservices,”saysMargaretRobinson,SeniorVicePresidentofPatientCare.“WeultimatelywentwithValuMetrix®becausetheyhadastrongerbackgroundinthelaboratory.Andtheywouldgiveusalongersupportperiod,whichwefeltwasnecessary.”
Assessmentfindspotentialfor“realimprovementalmostimmediately”
ApreliminaryValuMetrix®assessmentfoundnumerousopportunitiestoeliminatewasteandfunctionsmoothlywithlessstaffing.Thelab’slayoutwascompartmentalized,requiringemployeestowalklongdistances.Operating
proceduresincludedrepetitiveorentirelyunnecessarysteps.“Theassessmentshowedthatwehadmorethanjustacoupleofplaceswherewecouldimprove,”saysMr.Williams.“Infact,therewereareaswherewecouldgetsomerealimprovementalmostimmediately.”
Afive-personLeanteamwasformedtogatherthenextlevelofnecessarydetail.ItsmembersbeganwithseveraldaysoftrainingfromaValuMetrix®consultant.Theydefinedthescopeoftheirprojectandconductedsmallpartsofittoapplywhattheywerelearning.
Isolatedlocationcreatesaconstantlaborshortage“Asidefromanothertownabout20milesaway,there’snothingoutherefor100milesinanydirection,”saysMarkWilliams,CoreDepartmentManageratMidlandMemorialHospitalinMidland,Texas.“Wedon’thavealotofemployeeslookingtocometothisarea.”
That’swhy,despiteagrowingworkvolume,MidlandMemorialsawlabpositionsremainunfilledforaslongasninemonths.“Andalmostassoonasonewasfilled,anotherwouldopen,”Mr.Williamssays.“Weneededtodo
somethingtomakesurethatwecouldmeettheneedsofthehospital.”
LEAN
SNAPSHOT
CLIENTRESULTS
LaboratoryofMidlandMemorialHospitalinMidland,Texas
VITALS
•Testingturnaroundtimesimprovedbyasmuchas42%.•ThelabreassignedthreeFTEsandisnolonger
pursuingtwounfilledpositions,resultinginasavingsofmorethan$84,000.•Overtimeusagewasreducedby71%,foranannuallaborsavingsofroughly$66,000.•Thelabrecovered775sq.ft.offloorspaceforapharmacyexpansion.
•66FTEs
•525,000testsperyear
PROJECTGOAL
•Reducelaborrequirementsandhelpthelabcopewithatightjobmarket•Improvetestingturnaroundtime
PROCESS
RESPONSE
UndertheguidanceofaValuMetrix®consultant,aLeanteamvideotapedeverystepofthetestingprocessandnotedhoweachsecondofprocessingtimewasspent.Itidentifiedbatchprocessing,aninefficientlayout,andpoorinventorymanagementasprimarysourcesofwaste.Theteamdesignedamorecentralizedlayout,switchedthelabtosingle-pieceprocessing,andinstitutedaformalinventorymanagementsystem.
“Somuchinformationisavailablethesedaysandpeoplehaveachoicewheretheywanttogoforhealthcare…Leanletsusprovideconsistentlygoodresultsandhigh-qualityworkwiththeresourceswehave.”
MarkWilliams
CoreDepartmentManagerMidlandMemorialHospitalMidland,Texas
StatSpin®isaregisteredtrademarkofIRISInternational,Inc.
HealthcareinstitutionsofanysizecanreduceexpensesandenhancetheirrevenuewithValuMetrix®Services.Toensurepermanentgains,weworkcloselywithyourmanagementandstafftoinstitutionalizethechanges.Bestofall,wetrain,mentor,andcertifyyourpersonnel,givingthemtheknowledge,tools,andskillstomakefurtherimprovementsontheirown.
1001USRoute202,Raritan,NJ08869-0606
1-800-523-6911,Ext.3821|www.orthoclinical.com
“Notonlydidturnaroundtimesimprove,theyalsobecamemoreconsistent.Thishasledtoanoticeablereductionincomplaintsfromnursesandphysicians.Now,whenprovidersdocall,thelabisbetterabletogivespecificanswers.”
BEFORELean:Ofthe35minutesbetweenachemistry
test’sarrivalandthefinalresult,only11minuteswenttoactivitythatactuallyaddedvalue.
artment.Thatmeantasmanybeorderingthesameitem.onthormoreofsuppliesinoreinastoreroom.Thislediredsupplies.
BEFORELean:Whywerechemistryteststaking35minutes?Becausetheywerecarried84ft.andhandledeightdifferenttimes.vespace,nomorethanaweek’septintheworkarea.
AFTERLean:Technologistsnowtraceasimple,circularpathwhiletheyperformthemajorityofthelab’stests.•
•
Notonlydidturnaroundtimesimprove,theyalsobecamemoreconsistent.“Forexample,ourturnaroundtimesforurinalysistestsareplusorminusfiveminutesnow,”saysMr.Williams.“Before,itmightbe20minutesonedayand60minutesanother.”Thishasledtoanoticeablereductionincomplaintsfromnursesandphysicians.“Theyhadnoideawhenatestmightcomeback,”saysMs.Morris.“Sothe
perceptionwasthataCMPtookhours,eventhoughwecouldshowthat,onaverage,ittook44minutes.”
Whenprovidersdocall,thelabisbetterabletogivespecificanswers.“Becausewe’reonlydoingfourorfivetestsatatime,wehaveamuchclearerpictureofwhat’sgoingon,”saysMr.Williams.
$66,000savingsinovertimeusageand775sq.ft.ofrecoveredfloorspace
AndwhataboutMidlandMemorial’songoinglabor
shortage?Thepressureisoff,saysMs.Morris.Infact,thelabhasreassignedthreeFTEsandisnolongerpursuingtwounfilledpositions.Overtimeusagehasfallenby71%,fromanaverageof48shiftsamonthtojust14.Allthisaddsuptoroughly$150,000inannuallaborsavings.
Meanwhile,thestreamlinedlayoutandreducedneedforstoragehaveallowedthelabtocontribute775sq.ft.offloorspacetoapharmacyexpansion.Andthelabstillhasspacetoaddoutpatientorreferencelabservicesinthefuture.“It’sopenandreadyforuse,”Ms.Morrissays.
BEFORELean:
Withsuppliesoverstocked,itwasdifficulttonavigatethestoreroomandfindwhatyouneeded.
AFTERLean:
TheLeanteamdetermined
appropriatestockinglevelsandinsertedalaminatedcardatapresetreorderpointforeachitem.Whentechnologistsreachthereorderpoint,theysimplydropthecardintoabasket.
AFTERLean:
Thecardcontainsallthenecessaryinformationtoreordertheproduct.
AFTERLean:
Thestoreroomismoreopenandbetterorganized.
Howstandardworkraiseslab-wideperformanceAspartofitsLeanproject,MidlandMemorialdefinedastandard,optimalwaytoperformeachtask.“Oneofmyseniortechsresistedthatatfirst,”saysMarkWilliams.“Sheworriedthatwemightfindsomehappymedianandmakethatthestandardwayofworking.Butthat’snotwhatweweredoing.Weweretryingtotaketheverybestapproachandapplyittoeverybody.Onceshesawthat,andonceshesawhowalotofthosebestpracticeswerebasedonherwayofworking,sheunderstoodthatthiswasbetter.”Standardworkmakestrainingeasierbecauseitspecifieshoweachtaskshouldbeperformed.Itmakessupervisioneasieraswell.KimMorrisnotes,“IknowinthepastI’vecheckedonpeopleand,becauseeachpersonwasdoingtheworkdifferently,youhadtoassumetheyweredoingthingscorrectly.Buttheyweren’t.Having[standardwork]allowsforbetterobservation,bettermanagement.”ValuMetrix®consultantdemonstratesamorethoroughimprovementapproach
MidlandMemorialhastriedotherapproachestoqualityimprovement.“WeoncehadastaffinganalysisthattolduswhatourappropriateFTEmixshouldbe,”saysMargaretRobinson.“Buttheygaveusnoguidanceonhowtoaccomplishthat.Itwas,‘YouhavethreemoreFTEsthannecessary,figureitout.’”StaffmembersalsopursuedPDCA(Plan,Do,Check,Act)initiatives.“Butthatwasmoreofanindividualeffort,”saysMr.Williams.“Theoutcomesvariedandyouwouldoftenbackslide.Soyou’dreachtheconclusionthat,‘Thiscan’tbefixed.’”
Mr.WilliamscreditstheValuMetrix®consultantwithdemonstratingamorethoroughapproach.“Ifsomethingtook52steps,forexample,wemighthavewrittendownthe30mainones,”hesays.“Itwasimportanttohavetheconsultantsay,‘No,no.Youneedtorecordeverystep.’”Headdsthattheconsultantkeptaskingwhycertainprocessstepswereessentialuntilthestaffeventuallyrealizedthat…theyweren’t.
Theconsultantalsoprovidedmuch-neededconfidenceandcredibilitywhendrasticchangeswerecalledfor,accordingtoMs.Morris.Sherecalls,“Whenweexplainedhowtechswouldwalkinacircleinacorecell,peopleasked,‘Isthatreallygoingtowork?’Andtheconsultantcouldsay,‘Yes,itdoes.I’veseenitworkotherplaces.’”
AFTERLean:
Continuedgains:Thiscardcelebratesan
additionalimprovementthatwasimplementedbylabworkers.
AlastingLeanculture
Withthesuccessofthelabproject,MidlandMemorialisapplyingLeantootherareasofthehospital.AmajorLeaninitiativeistakingplaceinthehospital’sbloodbank.KimMorrishasledsmallprojectswiththepharmacyandMedicalStaffCredentialOffice.SheandPamGallickhaveevenhelpedorganizethehospital’slibraryinkeepingwithLeanprinciples.
AndwhiletheValuMetrix®consultanthasstayedintouch,providingfollow-upsupportviaphoneande-mail,MidlandMemorialseemstohaveacquiredaself-perpetuatingLeanculture.“IcantellfromtheinputIgetfrommystaff,eventheoneswhodon’tbelievewholeheartedlyintheprocess,”saysMr.Williams.“Theylookatcertainthingsandsay,‘Youknowwhat?Weneedtochangethis.Wemightneedtomovethisoverthere.’They’restilllookingforwaystoimproveonhowwedothings.”
ValuMetrix®isaregisteredtrademarkofOrtho-ClinicalDiagnostics.
©Ortho-ClinicalDiagnostics,Inc.2008OC10257
因篇幅问题不能全部显示，请点此查看更多更全内容