clinical pathology quality dashboard january 2010

Clinical PathologyQuality Dashboard

January 2010

Clinical Pathology Quality Dashboard

Inpatient Phlebotomy First AM Blood Draws

0%

20%

40%

60%

80%

100%

Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

2008 2009

University Hospital

8am

9am

10am

Drawn by

0%

20%

40%

60%

80%

100%


2008 2009

Mott Hospital

8am

9am

10am

Drawn by


Inpatient Phlebotomy First AM Blood Test Results:

PT/PTT, CBCP, and Comprehensive Panel

0

100

200

300

400

0%

20%

40%

60%

80%

100%


Av

g D

ail

y V

olu

me

2008 2009

University Hospital

8am

9am

10am

Results by

0

2

4

6

8

10

12

0%

20%

40%

60%

80%

100%


Av

g D

ail

y V

olu

me

2008 2009

Mott Hospital

8am

9am

10am

Results by

Inpatient Phlebotomy Draws


19,75920,459

19,598 19,795

21,992 21,71420,986

21,65122,073

22,675

20,208

22,942

21,65020,940

0

5,000

10,000

15,000

20,000

25,000

30,000

Nov Dec Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec

2008 2009

0

200

400

600

800

1000

1200

1400


Mo

nth

ly V

olu

me

2008 2009

Emergency Department Cardiac MarkerVolume and Turnaround Time

> 2 hours

1-2 hours

<1 hour

TAT


Turnaround Times

Point of Care service began

0

20

40

60

80

100

120

140

160


Mo

nth

ly V

olu

me

2008 2009

CSF Gram StainVolume and Turnaround Time

> 1 hour

30 min-1 hour

<30 minutes

TAT


Specimen Processing Turnaround TimeAverage Daily Turnaround Time + 1 standard deviation

for Inpatient Specimens going to Chemistry

September 2006 - July 2007

0:00

0:14

0:28

0:43

0:57

1:12

Sep-06 Oct-06 Nov-06 Dec-06 Jan-07 Feb-07 Mar-07 Apr-07 May-07 Jun-07

Tu

rnaro

un

d T

ime i

n M

inu

tes

0:00

0:14

0:28

0:43

0:57

1:12

Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09

Tu

rnaro

un

d T

ime in

Min

ute

s

January 2009- December 2009


Molecular Diagnostics Laboratory

0

1

2

3

4

5

6

7

8

9

10

0

200

400

600

800

1000

1200

1400

January 2002

July 2002

January 2003

July 2003

January 2004

July 2004

January 2005

July 2005

January 2006

July 2006

January 2007

July 2007

January 2008

July 2008

January 2009

July 2009

TAT

(day

s)

Spec

imen

s R

ecei

ved

per M

onth

Month/Year

Specimens Received and Turnaround TimeJanuary 2002 - December 2009

# Specimens TAT Linear (# Specimens) Linear (TAT)


Chemistry In-Lab Turnaround Times

0

5

10

15

20

25

30

Pe

rce

nta

ge

Sep 07 - Dec 09

Sample Turn-Around Time

Routine >60 min stat >45 min In pt. stat >45 min out pt. stat

UMHS Blood Product Utilization


0

1000

2000

3000

4000

5000

6000

7000

8000

0

1000

2000

3000

4000

5000

6000

7000

8000


Pa

tie

nt

Po

pu

lati

on

2008 2009

Blood Product Utilization

Random Platelets

Allo RBC Units

Plasma Units

Cryo Units

Partial Units

SD Platelets

AdjustedDischarges

Units Used

1.3

1.4

1.5

1.6

1.7

1.8

1.9


2008 2009

Crossmatch/Transfusion Ratio

Threshold

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%


2008 2009

Wasted RBC

Threshold

0%

1%

2%

3%

4%

5%


2008 2009

Wasted Platelets

Threshold

0%

1%

2%

3%

4%

5%

6%


2008 2009

Wasted Plasma

Threshold

0%

5%

10%

15%

20%

25%

30%


2008 2009

Wasted Cryoprecipitate

Threshold


CAP Proficiency Testing

2nd Quarter FY 2010

Clinical Pathology 126 = Number of Challenges 98% = Satisfactory ResultsAnatomic Pathology 0 = Number of Challenges N/A = Satisfactory ResultsDepartment Total 126 = Number of Challenges 98% = Satisfactory Results

100

9799.5 99 100

92

99 98

50

60

70

80

90

100

0

100

200

300

400

500

600

3rd Qtr 4th Qtr 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr 1st Qtr 2nd Qtr

Per

cen

t S

atis

fact

ory

Nu

mb

er o

f C

hal

len

ges

Clinical Pathology Scores

FY2008 FY2009 FY2010


CP Financial Measures

0

2

4

6

8

10

12

1.00

1.05

1.10

1.15

1.20

1.25

1.30

1.35

1.40

1.45

Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Blo

od

Pro

du

ct U

nit

s (t

ho

usa

nd

s)

Do

llars

(m

illio

ns)

pai

d t

o S

E

Mic

h A

mer

ican

Red

Cro

ss

2008 2009

Blood Costs vs. Total Blood Products Used

Units

Cost

$4

$5

$6

$7

$8

$9

$10

$11

Clinical Path Expense per Test*

* Excludes Blood Bank and Phlebotomy

275000

300000

325000

350000

375000

400000

425000

1,000

1,200

1,400

1,600

1,800

2,000

Tota

l Tes

ts

Test

per

FT

E

Clinical Path Tests per FTE and Total Tests By Month

Tests per FTE Total Tests

• Update of Clinical Laboratories Reflexive Testing List

• Formal Clinical Pathology Operations

Committee established

• 22 Sendout and/or highly esoteric tests were vetted in the laboratory Formulary Committee during 2009


Clinical Laboratory Operations Initiatives

• Establishment of new Outpatient test option that reflexively orders a urine culture based on selected urinalysis results

• Standardized and clarified reporting of fecal

occult blood testing results and completed • Dr. Lina Shao (Cytogenetics) joined the

Department of Pathology


Clinical Laboratory Service Enhancements

• Congratulations to Chemistry and Microbiology; NO CSF Gram stains have taken more than 1 hour to complete – for two consecutive months

• CAP Proficiency Testing Performance for FY10 second quarter – was outstanding! (98% satisfactory results on 126 challenges)

• December, 2009 marked the “best ever” performance in Mott Hospital AM blood draws completed before 10 AM


Kudos

clinical pathology quality dashboard january 2010

Documents

chemistry slide

blood draws slide

comprehensive panel

lab turnaround times

blood test results

selected urinalysis

number of challenges

inpatient specimens