1. LEAN IN THE LABORATORY Linda Whaley, MS, RN Vice-President Clinical Services Anne Iehl, MT (ASCP) Assistant Lab Manager

2. GOALS: 1. 90% of morning work completed by 8 A.M. 2. Reduce turn-around time of lab results. 3. Improve physician satisfaction.

3. GOALS: First Step: Begin 5 S’s SORT STRAIGHTEN SHINE STANDARDIZE SUSTAIN

4. STANDARDIZED PHLEBOTOMY TRAYS

6. GOALS:

7. PHLEBOTOMY – 5:30 AM Start Time Small Tests of Change: 1. Draw 3 transport to lab May 21-May 31 ● Of 9 monitored days, obtained 90% goal 2 times (22%) 2. Runner June 1-June 21 ● Of 21 monitored days, obtained 90% goal 14 times (66%) 3. Swarming June 22-June 28 ● Of 7 monitored days, obtained 90% goal 1 time (14%) Result: Runner implemented One additional person added to 5:30 AM shift

8. GOALS: OUTPATIENT SPECIMEN PROCESS Changed location of OP phlebotomy from Main Lab to Front Entrance area with pneumatic tube system. Main Lab Distance = 420 feet Front Entrance Distance = 150 feet

9. GOALS: PROCESS CHANGE: Conversion Of Collection Tubes

10. GOALS: PROCESS CHANGE: NURSING HOME SUPPLY LIST

11. GOALS: PHYSICAL CHANGES: WORK AREA PRE-LEAN

12. GOALS: PHYSICAL CHANGES: WORK AREA POST-LEAN

13. GOALS: PHYSICAL CHANGES: MONITOR

14. GOALS: PHYSICAL CHANGES: SUPPLY CART PRE-LEAN

15. GOALS: PHYSICAL CHANGES: SUPPLY CARTS POST-LEAN

16. GOALS: AUTOMATED LINE Before Automated Line After Automated Line

17. GOALS: GOAL SUMMARY 1. 90% of morning work completed by 8 AM ● Pre-LEAN: 45% of work complete by 8 AM March 2010: 90% of work complete by 8 AM ● Standardized Phlebotomy Trays Pre-LEAN: Over 30 trays March 2010: 10 Standardized trays ● Scheduled 2 nd phlebotomist at 5:30 AM ● Implemented a “runner” ● Nurses doing central line blood draws

18. GOALS: GOAL SUMMARY 2. Reduce turn-around time of lab results ● Specimen drop-off area ● Efficient “race track” layout of lab ● Conversion of collection tubes

19. GOALS: GOAL SUMMARY 3. Improve physician satisfaction ● Plan to re-survey physicians May 2010

20. GOALS: Other LEAN Process Improvements Front Entrance Specimen Process ■ Outpatient blood draws ■ Client drop off Supply Inventory Time clock added closer to Lab (approx. saving = $6552/yr.)

21. GOALS: PLANS FOR 2010 1.Standardize storeroom supplies ● Main Lab ● Front Entrance 2.Auto-verification 3.Standardize phone system 4.Sustain turn-around-time improvement!

22. GOALS: QUESTIONS?