LEAN SCORE Report

S-SelectPROBLEM STATEMENT:

A problem statement has the form:

WHAT is wrong

WHERE it happened

WHEN it occurred

TO WHAT EXTENT

I KNOW THAT BECAUSE…

EVENT OBJECTIVE:

Define what metrics will be used to measure success.

Hat specific outcome is desired.

TEAM MEMBERSHIP:

Select 4-8 frontline/interdisciplinary team members

E-EvaluateE-Evaluate C-Clarify C-Clarify

R-RunR-Run

O-Organize O-Organize

Validate the extent of the problem:•Interview staff/illicit feedback•Watch work (Go & See)•Root cause analysis- used to identify and prioritize all possible causes for the problem. Keep asking “why?”•Ask the 5 Why’s•Gather pertinent data: may include value stream amp, process map, pareto graph, spaghetti diagram, flow chart, layout diagram.

Organize/ list activities to be completed before the RUNPictures of Action Item Lists5 S Before and After pictures if applicable

List of improvements to be trialed.May include pictures of developed schedules, forms, etc to be trialed.Proposed Future State Process Map to be trialed.

Event objectives achieved through:

Future work includes: describe how you will sustain the process.i.e. audit schedule, monthly data evaluation, etc.

Include data and graphs depicting selected metrics from before and after the process change.

Refer to example completed LEAN SCORE report

GNCH LEAN LAB Project # 3 – “As the Tube Turns”

S -Select

PROBLEM STATEMENT: Currently there exists a large amount of variation in the time a blood sample is receipted in the lab to when it is resulted after being analyzed.

EVENT OBJECTIVE: Improve (R-R) receipt to result time for Lytes/EP, Hgb, PT & Troponin for NU 42,51,54 & ED patients

TEAM MEMBERSHIP:

Bruce Lyon Brenda Lunty

Karin Moses Susanne Hrudey

Shannon Austman Ann Arseneau

Lissette Guajardo Sherry Ramsaran

Charlene Kerr Carol Mikulin

LAB CART

FREEZER

Printe

r

Printer

STAT Log Sheets

LAB CART

Lab Tray Lab Tray

Mai

l Box

es

Paper Cutter

Main Accessioning

Computer

Data Entry A

Reqs/

Filing

Emergency

Phone

Reqs for RT to

run – ICa

Specimen

Receiving

Window

FAX

Machine

Main

Printer

Storage (Bags, Staplers,

Stickers)

Sink

TO CORE LAB

Label

Printer

Rack

Storage

(Blood Band

Supplies)

CottonBalls

Label

Printer

Data Entry BReferral

Bin

Main Bench & Labeling Station

Evenings/Nights

Referrals

Centrifuge

Bin

ER Lift

White Board

U-Shaped Cell Design

TO

PA

TH

OL

OG

Y &

R

EF

ER

AL

LA

B

LEAN LAB Project #3

COAG

BrendaKarin

HEMATOLOGY

CHEMISTRY

Su

pp

ly C

art

-In Bucket-Balance Tube-Stat rack-Spun Sample rack

Co

nfi

de

nti

al

Bin

Bookshelf

Cold Spin 2 3 4

Plasma Thaw

Centrifuges STAT Spin

Bins

SP

EC

IAL

BE

NC

H

FF

NE

SR

STAT Spin

NB

il

Co

nfi

de

nti

al

Bin

SA

FE

TY

E

QU

IPT

ME

NT

BLOOD BANK

R-RunR-Run

C-ClarifyC-Clarify

Receive samples from Units and Lab Assists

Data Entry/ Sort/ Barcode Label Specimens

CentrifugeAlliquot if needed

Deliver specimens to benches

Receive phone callsAnswer Questions

Add OnsRespins for off Line

Hospital Bench(PreAnalytics)

Pull Received List & Edit (CT 20 min)Pull Collection List & Labels @ 0300h

(CT 5 min)Sort Collection List in Piles (CT 15-30

min)

Prepare Collection

Lists

X Reference Unit Collection Log (CT

5 min)Collect Specimens

Until Done or Coffee (CT 60-120

min)

Check Schedule (CT 2 min)

Pick up Assigned Pile (CT 1 min)

Prioritize Collections (CT 2-

5 min)Set up Collection

Tray/ Cart (CT 2-5 min)

Collect Specimen

Prepare for Specimen Collection

Call Porter for STATS &

specimens (??)Return to LAB with Collected

Specimens (CT 2-5 min)

(CT 1-2 min)(CT 10 min/batch)

75% MLA’s25% Lab

Tech’s(CT 2-5

min)

(CT 1 min)

DeliverSpecimen

LABELCLVS or

REISORT

(CT 1 min)(CT 15 min)(CT 1min)

DELIVER to

Centrifuge

Specimen Loading/ Spinning

Deliver to Testing

Bench

Customer ServiceInventory

GNCH Pre-Analytical Current State Hospital BenchWaste Identification/ Areas of Improvement

InventoryInventoryInventory Inventory

5 ‘SFlow

Improvements

Roles and Responsibilities

Decrease Batching of Specimens

Balance Workload

Customer Demand: 0600h-0900h180 min/135 collections

Takt Time: 1.3 min

CT 30-55 min CT 7-13 min CT 65-125 min) CT 2-5 min CT 2-5 min CT 10 min CT 1 min CT 1min CT 15 min CT 1 min

Priority and Stat blood samples for inpatients are mixed with Routine samples until they reach the MSR bench.

Layout

AREA OF IMPROVEMENT

O-OrganizeO-Organize

E-EvaluateE-Evaluate

Removal of 32 SOP binders

Reorganization of special bench & supplies

Reorganization of Blood Bank bench

Creation of U shaped cell design for data ‘A’ bench

Removal of 32 SOP binders

Reorganization of special bench & supplies

Reorganization of Blood Bank bench

Creation of U shaped cell design for data ‘A’ bench

Currently, lab staff have undefined orundesignated roles and responsibilities for handling & delivering blood samples to the centrifuges and/or testing benches.

Currently, lab staff have undefined orundesignated roles and responsibilities for handling & delivering blood samples to the centrifuges and/or testing benches.

5S5S

FLOW IMPROVEMENTSCreated a ‘SPIN’ bench- improved internal flowStat spin moved to Chem bench- reduced lead time for (+)TroponinsVisual cue- centrifuges visible by MLT’sDeveloped roles and responsibilities for blood sample handling- decreased motion

FLOW IMPROVEMENTSCreated a ‘SPIN’ bench- improved internal flowStat spin moved to Chem bench- reduced lead time for (+)TroponinsVisual cue- centrifuges visible by MLT’sDeveloped roles and responsibilities for blood sample handling- decreased motion

Event objectives achieved through: Developed SOP’s. Improved (R-R) time for specific NU. Improved specimen flow to the core lab. Visual cues and organization of cell groups improved lab flow.

Future work includes: Monitor process to ensure changes in work flow are built into daily work, maintained and sustained. Evaluate ongoing data.

Event objectives achieved through: Developed SOP’s. Improved (R-R) time for specific NU. Improved specimen flow to the core lab. Visual cues and organization of cell groups improved lab flow.

Future work includes: Monitor process to ensure changes in work flow are built into daily work, maintained and sustained. Evaluate ongoing data.

PTCollect to

Receipt Time (Median Minutes)

Collect to Result Time

(Median Minutes)

Receipt to Result Time

(Median Minutes)

25July 2010 26.5 60 29

August 2010 23 55 29September 2010 23 59 30

October 2010 24 57 29November 2010 21.5 53 28December 2010 23 52 27

GNCH 2010-2011 90% Median Lab Turnaround Times (0600-0900) Units 42, 51, 54, Emergency and

Emergency In-Patients by Test

GOAL:

LEAN SCORE Report

S-SelectPROBLEM STATEMENT:

EVENT OBJECTIVE:

TEAM MEMBERSHIP:

E-EvaluateE-Evaluate C-Clarify C-Clarify

R-RunR-Run

O-Organize O-Organize

Event objectives achieved through:

Future work includes: