Inpatient preanalytic process improvements

Inpatient preanalytic process improvements

Phlebotomy services are a common target for preanalytic improvements. Many new, quality engineering tools have recently been applied in clinical laboratories. However, data on relatively few projects have been published. This example describes a complete application of current, quality engineering t...

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Bibliographic Details
Published in:Archives of pathology & laboratory medicine (1976) Vol. 137; no. 12; pp. 1753 - 1760
Main Authors: Wagar, Elizabeth A, Phipps, Ron, Del Guidice, Robert, Middleton, Lavinia P, Bingham, John, Prejean, Cheryl, Johnson-Hamilton, Martha, Philip, Pheba, Le, Ngoc Han, Muses, Waheed
Format: Journal Article
Language:English
Published: United States College of American Pathologists 01-12-2013
Subjects:
Analysis
Bioengineering - instrumentation
Bioengineering - trends
Blood banks
Cancer
Control charts
Goals
Humans
Inpatients
Intensive care
Laboratories, Hospital - standards
Market surveys
Medical errors
Medical laboratories
Medicine
Phlebotomy
Phlebotomy - methods
Phlebotomy - trends
Quality Assurance, Health Care - standards
Quality improvement
Response time
Six Sigma
Time Factors
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Summary:Phlebotomy services are a common target for preanalytic improvements. Many new, quality engineering tools have recently been applied in clinical laboratories. However, data on relatively few projects have been published. This example describes a complete application of current, quality engineering tools to improve preanalytic phlebotomy services. To decrease the response time in the preanalytic inpatient laboratory by 25%, to reduce the number of incident reports related to preanalytic phlebotomy, and to make systematic process changes that satisfied the stakeholders. The Department of Laboratory Medicine, General Services Section, at the University of Texas MD Anderson Cancer Center (Houston) is responsible for inpatient phlebotomy in a 24-hour operation, which serves 689 inpatient beds. The study director was project director of the Division of Pathology and Laboratory Medicine's Quality Improvement Section and was assisted by 2 quality technologists and an industrial engineer from MD Anderson Office of Performance Improvement. After implementing each solution, using well-recognized, quality tools and metrics, the response time for blood collection decreased by 23%, which was close to meeting the original responsiveness goal of 25%. The response time between collection and arrival in the laboratory decreased by 8%. Applicable laboratory-related incident reports were reduced by 43%. Comprehensive application of quality tools, such as statistical control charts, Pareto diagrams, value-stream maps, process failure modes and effects analyses, fishbone diagrams, solution prioritization matrices, and customer satisfaction surveys can significantly improve preset goals for inpatient phlebotomy.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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content type line 23
ISSN:0003-9985
1543-2165
1543-2165
DOI:10.5858/arpa.2012-0458-OA