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- Title
Inpatient Preanalytic Process Improvements.
- Authors
Wagar, Elizabeth A.; Phipps, Ron; Del Guidice, Robert; Middleton, Lavinia P.; Bingham, John; Prejean, Cheryl; Johnson-Hamilton, Martha; Philip, Pheba; Ngoc Han Le; Muses, Waheed
- Abstract
Context.-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. Objectives.-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. Design.-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. Results.-After implementing each solution, using wellrecognized, 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%. Conclusions.-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.
- Subjects
TEXAS; ACADEMIC medical centers; COLLECTION &; preservation of biological specimens; CONFIDENCE intervals; HOSPITAL laboratories; LONGITUDINAL method; MANAGEMENT; EVALUATION of medical care; PHLEBOTOMY; PROBABILITY theory; QUALITY assurance; SYSTEM analysis; T-test (Statistics); TIME; TURNAROUND time; DATA analysis software
- Publication
Archives of Pathology & Laboratory Medicine, 2013, Vol 137, Issue 12, p1753
- ISSN
0003-9985
- Publication type
Article
- DOI
10.5858/arpa.2012-0458-OA