Transcript Slide 1

LEAN SCORE Report
S-Select
PROBLEM STATEMENT:
A problem statement has the form:
WHAT is wrong
WHERE it happened
WHEN it occurred
TO WHAT EXTENT
I KNOW THAT BECAUSE…
R-Run
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 OBJECTIVE:
Define what metrics will be used to measure success.
Hat specific outcome is desired.
TEAM MEMBERSHIP:
Select 4-8 frontline/interdisciplinary team members
C-Clarify
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.
E-Evaluate
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.
O-Organize
Organize/ list activities to be completed before the RUN
Pictures of Action Item Lists
5 S Before and After pictures if applicable
Refer to example completed
LEAN SCORE report
GNCH LEAN LAB Project # 3 – “As the Tube Turns”
S -Select
R-Run
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.
Supply Cart
COAG
CHEMISTRY
EVENT OBJECTIVE: Improve (R-R) receipt to result time for Lytes/EP,
Hgb, PT & Troponin for NU 42,51,54 & ED patients
HEMATOLOGY
-In Bucket
-Balance Tube
-Stat rack
-Spun Sample
rack
GNCH Pre-Analytical Current State Hospital Bench
Waste Identification/ Areas of Improvement
Customer Demand: 0600h-0900h
180 min/135 collections
Takt Time: 1.3 min
Flow
Improvements
Roles and
Responsibilities
Inventory
Prepare
Collection
Lists
Prepare for
Specimen
Collection
Collect
Specimen
Deliver
Specimen
SORT
Pull Received List
& Edit (CT 20 min)
Pull Collection List
& Labels @ 0300h
(CT 5 min)
Sort Collection List
in Piles (CT 15-30
min)
Check Schedule
(CT 2 min)
Pick up Assigned
Pile (CT 1 min)
Prioritize
Collections (CT 25 min)
Set up Collection
Tray/ Cart (CT 2-5
min)
X Reference Unit
Collection Log (CT
5 min)
Collect Specimens
Until Done or
Coffee (CT 60-120
min)
Call Porter for
STATS &
specimens (??)
Return to LAB
with Collected
Specimens (CT
2-5 min)
75% MLA’s
25% Lab
Tech’s
(CT 2-5
min)
CT 7-13 min
CT 65-125 min)
CT 2-5 min
CT 2-5 min
CT 30-55 min
Inventory
Inventory
CLVS or
REI
LABEL
(CT 1-2 min)
(CT 10 min/batch)
(CT 1 min)
DELIVER
to
Centrifuge
Specimen
Loading/
Spinning
(CT 1min)
(CT 15 min)
(CT 1 min)
CT 15 min
CT 1 min
Deliver
to Testing
Bench
AREA OF IMPROVEMENT
CT 10 min
CT 1 min
CT 1min
Priority and Stat blood samples for inpatients are mixed with Routine samples until they reach the MSR bench.
Brenda
GNCH 2010-2011 90% Median Lab Turnaround
Times (0600-0900) Units 42, 51, 54, Emergency and
Emergency In-Patients by Test
Reorganization
of special bench
& supplies
Specimen
Receiving
Window
FREEZER
STAT Log Sheets
PT
ER Lift
Paper
Cutter
White
Board
Evenings/Nights
Referrals
Centrifuge
TO CORE LAB
Bin
Emergency
Phone
Main Bench &
Labeling Station
Label
Printer
Collect to
Receipt Time
Collect to
Result Time
Receipt to
Result Time
(Median Minutes)
(Median Minutes)
(Median Minutes)
Reqs for RT to
run – ICa
Storage
(Blood Band
Supplies)
Rack
GOAL:
Storage
(Bags, Staplers,
Stickers)
Data Entry B
Referral
Bin
Lab Tray
Printer
Creation of U
shaped cell
design for data ‘A’
bench
STAT
Spin
Future work includes: Monitor process to ensure changes in work
flow are built into daily work, maintained and sustained. Evaluate
ongoing data.
Removal of 32
SOP binders
 Reorganization
of Blood Bank
bench
4
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.
O-Organize
5S
3
Centrifuges
E-Evaluate
es
Hospital Bench
(PreAnalytics)
Receive samples from Units
and Lab Assists
Data Entry/ Sort/ Barcode
Label Specimens
Centrifuge
Alliquot if needed
Deliver specimens to
benches
Receive phone calls
Answer Questions
Add Ons
Respins for off Line
Inventory
Box
Inventory
Currently, lab staff
have undefined or
undesignated roles
and responsibilities
for handling &
delivering blood
samples to the
centrifuges
and/or testing benches.
Mail
Customer Service
2
FLOW IMPROVEMENTS
Created a ‘SPIN’ bench- improved internal flow
Stat spin moved to Chem bench- reduced lead time for (+)Troponins
Visual cue- centrifuges visible by MLT’s
Developed roles and responsibilities for blood sample handling- decreased motion
Lab Tray
Reqs/
Filing
LAB CART
Main Accessioning
Computer
Main
Printer
Data Entry A
FAX
Machine
LAB CART
Label
Printer
Sink
TO PATHOLOGY &
REFERAL LAB
Decrease
Batching of
Specimens
Balance
Workload
Plasma Thaw
Bins
Cold Spin
Karin
Printer
5 ‘S
Confidential Bin
Bookshelf
C-Clarify
Layout
BLOOD BANK
Confidential Bin
FFN
Brenda Lunty
Susanne Hrudey
Ann Arseneau
Sherry Ramsaran
Carol Mikulin
SAFETY
EQUIPTMENT
TEAM MEMBERSHIP:
Bruce Lyon
Karin Moses
Shannon Austman
Lissette Guajardo
Charlene Kerr
SPECIAL BENCH
ESR
NBil
STAT Spin
U-Shaped Cell
Design
LEAN LAB Project #3
Cotton
Balls
July 2010
August 2010
September 2010
October 2010
November 2010
December 2010
26.5
23
23
24
21.5
23
60
55
59
57
53
52
25
29
29
30
29
28
27
LEAN SCORE Report
S-Select
R-Run
C-Clarify
E-Evaluate
PROBLEM STATEMENT:
EVENT OBJECTIVE:
TEAM MEMBERSHIP:
Event objectives achieved through:
Future work includes:
O-Organize