Clinical Pathology Quality Dashboard
Inpatient Phlebotomy First AM Blood Draws University Hospital
0%
20%
40%
60%
80%
100%
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
2008 2009
8am
9am
10am
Drawn by
Mott Hospital
0%
20%
40%
60%
80%
100%
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
2008 2009
8am
9am
10am
Drawn by
Clinical Pathology Quality Dashboard
Inpatient Phlebotomy First AM Blood Test Results:
PT/PTT, CBCP, and Comprehensive Panel University Hospital
0%
20%
40%
60%
80%
100%
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
2008 2009
0
100
200
300
400
Av
g D
ail
y V
olu
me
8am
9am
10am
Results by
Mott Hospital
0%
20%
40%
60%
80%
100%
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
2008 2009
0
2
4
6
8
10
12
Av
g D
ail
y V
olu
me
8am
9am
10am
Results by
Inpatient Phlebotomy DrawsFiscal Year 2009
Clinical Pathology Quality Dashboard
21,182
23,348
19,773
26,062
19,75920,459
19,598 19,795
21,992 21,71420,986
21,651
0
5,000
10,000
15,000
20,000
25,000
30,000
July Aug Sep Oct Nov Dec Jan Feb Mar Apr May June
2008 2009
Clinical Pathology Quality Dashboard
Turnaround Times
CSF Gram StainVolume and Turnaround Time
0
20
40
60
80
100
120
140
160
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
2008 2009
Mo
nth
ly V
olu
me
> 1 hour
30 min-1 hour
<30 minutes
TAT
Emergency Department Cardiac MarkerVolume and Turnaround Time
0
200
400
600
800
1000
1200
1400
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
2008 2009
Mo
nth
ly V
olu
me
> 2 hours
1-2 hours
<1 hour
TAT
Point of Care service began
Clinical Pathology Quality Dashboard
Molecular Diagnostics Laboratory
Specimens Received and Turnaround TimeJanuary 2002 - December 2008
0
200
400
600
800
1000
1200
1400
January2002
July 2002 January2003
July 2003 January2004
July 2004 January2005
July 2005 January2006
July 2006 January2007
July 2007 January2008
July 2008
Month/Year
# of
Spe
cim
ens
rece
ived
0
1
2
3
4
5
6
7
8
9
10
TAT
(day
s)
# Specimens TAT Linear (# Specimens) Linear (TAT)
Clinical Pathology Quality Dashboard
Chemistry In-Lab Turnaround Times
Sample Turnaround Time
0
5
10
15
20
25
30
35
Aug 07 - May 09
Pe
rce
nta
ge
Routines >60 min stat
>45 min In pt stat >45 min Out pt stat
UMHS Blood Product Utilization
Clinical Pathology Quality Dashboard
Crossmatch/Transfusion Ratio
1.3
1.4
1.5
1.6
1.7
1.8
1.9
J uly Aug Sep Oct Nov Dec J an Feb Mar Apr May J une
2008 2009
Threshold
Wasted RBC
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
3.0%
J uly Aug Sep Oct Nov Dec J an Feb Mar Apr May J une
2008 2009
Threshold
Wasted Platelets
0%
2%
4%
6%
8%
J uly Aug Sep Oct Nov Dec J an Feb Mar Apr May J une
2008 2009
Threshold
Wasted Plasma
0%
1%
2%
3%
4%
5%
6%
J uly Aug Sep Oct Nov Dec J an Feb Mar Apr May J une
2008 2009
Threshold
Wasted Cryoprecipitate
0%
5%
10%
15%
20%
25%
30%
J uly Aug Sep Oct Nov Dec J an Feb Mar Apr May J une
2008 2009
Threshold
Blood Product Utilization
0
1000
2000
3000
4000
5000
6000
7000
8000
July Aug Sep Oct Nov Dec Jan Feb Mar Apr May June
2008 2009
0
1000
2000
3000
4000
5000
6000
7000
8000
Pa
tie
nt
Po
pu
lati
on
Random Platelets
Allo RBC Units
Plasma Units
Cryo Units
Partial Units
SD Platelets
AdjustedDischargesUnits Used
Clinical Pathology Quality Dashboard
CAP Proficiency Testing
4th Quarter FY 2009
Clinical Pathology 91 = Number of Challenges 92% = Satisfactory Results
Anatomic Pathology 0 = Number of Challenges N/A = Satisfactory Results
Department Total 91 = Number of Challenges 92% = Satisfactory Results
Clinical Pathology Scores
92
1009999.597
1009998
0
100
200
300
400
500
600
1st Qtr 2nd Qtr 3rd Qtr 4th Qtr 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
Nu
mb
er o
f C
hal
len
ges
50
60
70
80
90
100
Per
cen
t S
atis
fact
ory
FY2008 FY2009
Clinical Pathology Quality Dashboard
CP Financial Measures
Monthly Amount Paid to Southeastern Michigan American Red Cross
1,000,000
1,050,000
1,100,000
1,150,000
1,200,000
1,250,000
1,300,000
1,350,000
Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun
FY 2009
Do
llars
Clinical Path Tests per FTE and Total Tests By Month
1,000
1,200
1,400
1,600
1,800
2,000
Tes
t p
er F
TE
275,000
300,000
325,000
350,000
375,000
400,000
425,000
To
tal
Test
s
Tests per FTE Total Tests
Clinical Path Expense per Test*
$4
$5
$6
$7
$8
$9
$10
*excludes Blood Bank and Phlebotomy
Clinical Pathology Quality Dashboard
New Clinical Assays Added in Current Year
Iohexol by UPLC-LC-MS/MS
Ethyl glucuronide by EIA
CEBPA mutation detection; prognosis in AML
Direct detection/differentiation of methicillin-sensitive Staph aureus (MSSA) and methicillin-resistant Staph aureus (MRSA) from blood cultures
Mycobacteria sp.-automated detection system
Many others listed in March-June dashboards
• Lean Process Improvements – Many!
• Work – station specific safety signs
• Blood Product Utilization Lean Team - Tim Laing, M.D. (OCA), Lead
Clinical Pathology Quality Dashboard
Clinical Laboratory Operations Initiatives