1. Colleen Jarosz, Cathy Lai, Dan Post and Cathy Shipp
LOYOLA OUTPATIENT CENTER PHLEBOTOMY PATIENT ENCOUNTER TIMES “Hurry Up and Stick Me!”
Colleen Jarosz, Cathy Lai,
Dan Post and Cathy Shipp

2. Opportunity Statement and Desired Outcome
Waiting for services is a significant patient “dis-satisfier”
Patients and physicians perceived the “wait time” for phlebotomy in the LOC laboratory to be “too long”
Patients routinely complained to their physician
Time monitors by laboratory management have typically been defined as the time from registration until the completion of the phlebotomy or “Encounter Time”
GOAL: REDUCE AVERAGE PATIENT ENCOUNTER TIME BY 15%

3. Most Likely Causes for Current Opportunity
Mis-match of phlebotomist work hours (Supply) and patients presenting for service (Demand)
Limited opportunities for changes to staffing patterns based on current hours of operation and current full time staff
Mis-match of phlebotomists skills and job tasks – phlebotomists performing computerized test requisitioning (data entry)

4. Uncontrollable Variables Affecting Encounter Time
Patient Arrival Times – Phlebotomy is a “walk-in” service. Patients are seen without appointment
Additional Services Required – Phlebotomy staff also perform Electrocardiograms which prolong the encounter time
Patient Demographics – Pediatric patients generally require longer encounters

5. Solutions Implemented
Identified 7:00am – 11:00am as peak hours for patient “Demand”
Initiated pilot program to augment staffing with temporary part time phlebotomists allowing for operation of all phlebotomy stations during peak hours
Identified key employees with strong computer skills and redesigned workflow to allow one person to do all the computerized test requisitioning

6. Monthly Encounter Times Before Process Change
Encounter Time in Minutes Mean=13.58 17
UCL 16 15 14
Minutes
Mean 13 12 11
LCL
Jan 04
Feb 04
Mar 04
Apr 04
May 04
Jun 04
Jul 04
Aug 04
Sep 04

7. Monthly Encounter Times After Process Change
Encounter Time in Minutes New Mean=11.18 17
UCL 16 15 14
Mean
Minutes
UCL 13 12
Mean 11
LCL 10 9
LCL
Jan 04
Feb 04
Mar 04
Apr 04
May 04
Jun 04
Jul 04
Aug 04
Sep 04
Oct 04
Nov 04
Dec 04
Jan 05
Feb 05

8. Results and Analysis
Workflow changes to allow one person to perform computerized test requisitioning implemented September 27, 2004
Pilot program to augment staffing implemented October 4, 2004
Average patient encounter time dropped from 13.6 to 11.2, a reduction of 2.6 minutes or 17.7%!

9. Conclusions and Next Steps
Coordination of “Supply” and “Demand” is critical in providing prompt service throughout the day
The staffing pilot program proved the value of having additional staff available during the peak hours – plan to convert those temporary positions to permanent part time positions
Investigate additional opportunities to incorporate flexible staffing patterns
Continue to monitor