Last January, a Rapid Improvement Event (RIE) took place with the Hackley Campus Lab Assistants. Laura Juhnke (Lab Assistant), Romana Fusik (Lab Assistant), and Chevonne Robbins (Manager) worked on the problem of morning blood draws not be completed by the goal of 6:30 a.m. Draws need to be complete by 6:30 a.m. so that results can be available to providers for patient care at 7:00 a.m. Thirty percent of draws were occurring after 6:30 a.m., and draws were taking 10 minutes per patient.
The team looked at the current process, and found quite a bit of waste. All supplies and one computer for all lab assistants were on one large cart. The cart took a great deal of time to stock, and there was often a delay while staff waited for other colleagues to get the supplies they needed, or finish their documentation of the specimens. The single cart also led to extra motion as each colleague traveled from the individual patient rooms back to the cart. Also, lab assistants waited to send all specimen tubes down to the lab at one time after each unit was drawn. This led to delays in getting results to providers.
After taking the time to fully understand the current state and all of the waste, a future state was considered. The team had countless ideas to eliminate the different kinds of waste. One of the solutions was to add the software access needed by Lab Assistants to the existing computers in each nursing unit. This helped to decrease waiting for use of one computer and motion of the Lab Assistant.
Another solution was to get rid of the supply cart, and stock everything needed for the morning rounds directly on individual trays. This change decreased the practice of stocking more than what was needed on the large cart, waiting around the cart, motion of walking to the cart, and worked on rightsizing the inventory.
One more solution was to divide the labels in the morning so everyone got close to the same amount of patients to draw. Each Lab Assistant then sends down specimen in individual, smaller batches rather than collecting all the tubes into one bag. These solutions led to less waiting, and decreased the confusion of who was responsible for what work.
By working with those that do the work to change the work, the following results were achieved:
- 2 minutes 23 seconds saved per patient draw (10 minutes to 7 minutes 37 seconds)
- 66% improvement on decreasing draws greater than 6:30 a.m. (30% to 10%)
- 83% improvement on being staffed as planned (29% to 53%)
- Proven increase in colleague satisfaction
Following the event, all the first shift Lab Assistants got involved, continued to offer solutions, and helped to implement the ideas that came forth. They are continually encouraged by their manager to solve problems since they are the closest to the patient care.
Great job to Laura, Romana, Chevonne, and the entire 1st shift Hackley Campus Lab Assistant team!