Skip to contents
In This Issue:
OB, Pathology Complete Intensive Process Improvements
In a Pathology conference room, a group of managers and front-line staff are surrounded by large sheets of paper taped to all four walls. Each sheet of paper is peppered with post-its detailing improvement ideas, goals and action plans.
Across the hospital, a similar group sits in a Connors Center 7 conference room, discussing and trialing new ideas for process improvements.
This is how the Clinical Pathology and Obstetrics divisions both completed their last Kaizens, four-day intensive meetings where ideas on how to improve processes are brainstormed and put to the test.
“We’ve worked with Pathology and OB since last fall on process improvement,” said Dorothy Goulart, MS, RN, director of Performance Improvement in the Center for Clinical Excellence. “During the Kaizens, team members really hone in on ways to reduce and eliminate wastes in their processes. Small changes in a process can result in a meaningful savings of time and materials.”
Waste in a process includes things like waiting for a medication to be delivered or for someone to return a phone call; overproduction, such as making extra labels that go unused; extra processing; and travel time.
“Process improvement is very important for the Clinical Laboratories as part of our ongoing modernization and total lab automation initiative,” said Milenko Tanasijevic, MD, MBA, director of Clinical Pathology. “Because the laboratory environment is fundamentally process-driven, it really lends itself to this kind of work. In addition to distinct process improvements in multiple areas of the laboratory, the empowerment and level of enthusiasm among our front-line staff are the chief benefits from the Kaizen events.”
Improvements from the most recent of Pathology’s five Kaizens include a numbering system to reduce patient wait time and to manage patients’ expectations of their wait times in Outpatient Phlebotomy. “The patient wait times for blood collection at 45 Francis St. have dropped from an average of 21 minutes at the end of April to seven minutes as of last week,” said Margaret Lobo, director of Lab Support Services. “Patients and staff alike are thrilled with the new check-in procedure, and we are continuing to monitor wait times as part of our 30-day action plan.”
Further, the specimen processing steps were streamlined by introducing a team-based approach, resulting in faster turn-around times for multiple tests. Lidia DeMartino, senior medical technologist, took the reigns to reduce clutter throughout Clinical Chemistry, removing old equipment, standardizing inventory and freeing up floor and bench space. She and her group took the effort room to room within Clinical Pathology. “Every square foot of freed-up space counts as we prepare for automation,” Tanasijevic said.
In Obstetrics, triage was the first focus. “A group of staff nurses, materials management staff, unit coordinators and housekeepers participated in a Kaizen to figure out how to clean rooms faster and ensure rooms are always stocked appropriately,” said Maggie Hickey, RN, nurse manager of Labor and Delivery.
One solution was rearranging the drawers that hold materials in patient rooms. “Most patients need an IV, so we moved those from the bottom drawer to the top drawer and added more IV start kits,” Hickey said. “We took pictures of the newly-rearranged drawers so materials handlers always know what goes in each drawer.”
On the Labor and Delivery floor, housekeeping and Materials Management made another small improvement that is making a big impact on room turn-around time. Often, the materials handler would come to restock the room at the same time the housekeeper was cleaning and would need to come back after the room was cleaned. Now, the unit associate moves the cart outside of the room before cleaning, so that the handler can stock the cart at the same time.
In an effort to help nurses, slips of paper are positioned at the unit coordinator’s desk. If an OB nurse needs the unit coordinator to call Anesthesiology for an epidural, but the unit coordinator is handling another matter, the nurse can leave his or her name and room number on the paper that says, “I need an epidural,” and the unit coordinator follows up with a text page letting the nurse know it has been done.
Both OB and Pathology surveyed staff before and after the changes and continually gather data to sustain the improvements. “This process helps people develop a new way of thinking,” DeMartino said. “We continue to make changes because we look at things differently.”
Learn more about the improvements in Pathology and OB at Quality Rounds, June 10, at noon in the Anesthesia Conference Room, L1. Dorothy Goulart leads a panel presentation of team members and sponsors including Pathology’s Ellen Goonan and Lidia DeMartino and OB’s Margaret Hickey and Angelleen Peters-Lewis.