1. The Health Roundtable Innovations in Phlebotomy to Improve the Inpatient Diagnostic Service Presenter: Prem Kumar & Ailsa Bunker Hospital Code Name: Counties Manukau District Health Board, Auckland, New Zealand Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012

2. The Health Roundtable KEY PROBLEM Background: Middlemore is an 800 bed hospital in South Auckland with around 300 bloods collected by the morning Phlebotomy team. Phlebotomists were not finishing in their contracted shift of 0700 to 1100 hrs. Problem: The assumption from the Phlebotomy team was “we are not finishing on time therefore we need more staff”. However Phlebotomists were spending time on non- phlebotomy activities causing delay in blood results to the clinicians. This became the focus for improvement. We need more staff We need more staff We need more staff e need re staff We need more staff ed taff

3. The Health Roundtable AIM OF THIS INNOVATION To improve the productivity of the Phlebotomy process by reducing waste in terms of the time spent on non- phlebotomy activities. Waste in Process

4. The Health Roundtable BASELINE DATA Data was prospectively collected to reveal elements in the Phlebotomy process that were not adding value. Productivity = 49% Out of 60 min, 30 min is spent on non value adding activities 100%

5. The Health Roundtable KEY CHANGES IMPLEMENTED Request form management  Requester writes the room number and places it behind the correct room number. This saves 10 min per Phlebotomist per day Introduction of no wrist band signage  The Phlebotomist rings the patient bell and places the warning notice near the bell and goes to the next patient. The Nurse attends the bell and arranges the wrist band. At the end of the ward round Phlebotomist checks again and completes the collection This saves 10 min per patient with no wrist band

6. The Health Roundtable KEY CHANGES IMPLEMENTED  Phlebotomist rechecks patient availability at the end of the ward round. If still unavailable, complete “unavailable form" and Patient unavailability is communicated via “unavailable form” and online laboratory system. This saves 10 min per unavailable patient Handling unavailable patient situations Reason for unavailability

7. The Health Roundtable OUTCOMES SO FAR Post improvement audit indicated a productivity increase of 13%. Productivity Gain = 13% Per phlebotomist per day

8. The Health Roundtable LESSONS LEARNT  Significant improvements can be gained by simple innovations.  Engaging the team to generate ideas and drive improvements has ensured a sustained success.  That the fundamental issues to be dealt with may not be the issues which are initially assumed (e.g. More staffing). Issues should not be resolved in isolation.