Leo Serrano, FACHE, DLM(ASCP) Operations Manager FirstPath Laboratory Services Pompano Beach, Florida

Transcription

1 Leo Serrano, FAHE, DLM(ASP) Operations Manager FirstPath Laboratory Services Pompano Beach, Florida

2 Several Slides were provided by NovoPath and are identifiable by the NovoPath logo in the lower right hand section of the slide. The opinions and comments of this presentation are those of the speaker and do not represent the opinions or concepts of NovoPath. Slides and data are from FirstPath Laboratory Services LL.

3 We are a pathologist owned and directed Anatomic and linical Laboratory located in South Florida. We recently opened our linical Laboratory after being a strictly anatomic laboratory for nearly 20 years. FirstPath employs 15 Board ertified and Specialty certified/fellowship Trained Pathologists in addition to its laboratory professional and office staff. Additionally, FirstPath provides professional laboratory services to over 10 hospital facilities in the South Florida region including a large Health System, numerous physician groups and several LTAs.

4 Design the lab to bring the most value to the organization. Design work stations around processes. Place instruments in order of highest use. Reduce wasted movement and steps. Set workstation based on data, not whims or where ever there is a spot.

5 Track specimen flow to determine bottlenecks. Develop workflow based on current state Value Stream and Flow Diagram. Develop the Future State Value Steam and Workflow Diagram. Includes instrument placement

6 INSERT SAMPLE VSM

7 INREASED VALUE EFFIIENY PATIENT SAFETY STEAMLINE WORKFLO W MAP WORKFLOW IDENTIFY INEFFIIENIE S

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9 Original Anatomic/ytology layout has not changed since inception Placement and workflow set at discretion of employees Specimen flow was based on available space for equipment Time tracking was not available.

10 Original Lab Layout P c S L P OURIER PU/DROP P P AESSION AREA DAWN-LAB MGR PATHOLOGIST c h sk SPEIMEN REEIPT / SORTING frig e S M gross station sk Prisma stainer s k cytology e REST ROOM cry o work table for cases m storage shelf M P p ST p frige d e s k o

11 Workflow was based on equipment placement in any open space Intermixing of functions and processes Major need of 5 S (sort, set, shine, standardize, sustain) Need to instill change mindset. Used omputer System installation to assist.

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13 Picture of current lab cabinets, etc.

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15 Added Bar oding- reduced errors/tracked time at each step Provided Data Driven material to use for design Showed employees the bottle necks Laid out the employee flow showing retraced steps Showed each employee just how much time it took for each step.

16 ytology cases prepped in cytology area- NOT histology area. ytology cases are accessioned together with histology in a central anatomic accessioning area All preparation is maintained in a separate area. Thin-Prep processing performed in former pathology area. onventional Pap processing is performed in cytology area. Histology cases are accessioned in the Accessioning area then moved to Grossing Station on a cart. At that point, they follow the histology work flow.

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19 Specimens brought from Accessioning to Grossing on a cart. Specimen flows directly to the Left from Gross to Processor assettes flow from Processor to Embedding Stations Embedded cassettes flow from Embedding station to Microtomy Prepared slides flow from microtomy area to Prisma stainer Finished slides then flow from case assembly area directly to pathologist in the New linical Area. Finished slides are then moved to filing area in warehouse.

20 New Layout Office mgr. ENTRY WAY Outside porch L P P P P OURIER PU/DROP S AESSION AREA remains as is c DAWN-LAB MGR hand held/scanner cytology T 2 T5000 c yto hood Recept. New Layout Anatomic/ytology SPEIMEN REEIPT / SORTING frig e stain line sk Transcrip. REST ROOM REST ROOM TO NEW LAB frige REST ROOM gross station - new - w sink storage shelf p si n k HISTOLOGY m processors 2 wor k area for cases o M P S m-microtome o-oven embed Prisma stainer w waterbath M P m embed s k work space- assemble cases sp stain Old omputer room

21 Used the data from Anatomic to develop a workflow template Looked at where courier drop off would be and what major volume areas would be. Designed facility around processes Placed equipment in order of volumes

22 ourier enters building from loading dock- drops off at accessioning All linical Work is accessioned at one site by 1 to 2 people Specimens are moved via carts to appropriate areas. Workload by volume: Micro/Panther/Serology- largest volume hem/hem/ua next ore lab workload is an oval workflow manned by 1 person hem-> Hem-> UA -> oag -> sed rates/misc. Micro/Panther/Serology is a workcell manned by 1 person Accessioner does all plating of cultures after accessioning.

23 computer rm existing 12 X 10' reagent frige REA GEN T A D I ORE LINIAL TESTING cents p GATE scop e pathologist #2 incu bato r panther s i n k s i n k u scop e B scop e MIRO AREA p chemistr y mic fridg e micro hood pathologist #1 sn k Blood cultur e ADA RESTROO M sin k AESSIONING OUNTER p

24 After linical Lab Go-Live Proof of oncept trial begun. Avg Daily Accessions requisitions Avg Microbiology Workcell Accessions 40 to 80 specimens Avg ore Lab Accessions hemistry 30 to 40 Hematology 20 to 40 UA 20 to 30 oag 5 to 10 Misc. (ABO/Rh, Serology, etc) 20 to 30

25 Average Staffing per Shift (2 shifts) Technical Staff 2 technical staff (MLS Level) Accession Staff 1 to 2 (Lab Assistant Level) Work ell Staffing per Shift Micro/Panther Workcell 1 MLS ore Lab (hem/hem/ua/oag) 1 MLS Acccession/Micro Set up- 1 Lab Assistant

26 By tracking materials more closely, supply use is better controlled. We can track cassettes and slides using the system. At accession, cassettes are labeled by case- At microtomy, slide labels are prepared based on pre-determined data. In the clinical lab, client supply materials can be tracked and more closely controlled. lient supply requests are monitored and compared to client specimen numbers and types Goal is to avoid supply abuse by clients.

27 We plan on using the system to track time with mobile phlebotomists. Not done on a live basis at this time- use clock in time of phlebotomist and the collection time on the requisition to track data Data evaluated as to average time of collection, location of collection, etc. Future use includes tracking ourier Routes and volumes Expect to use this process after we have fine-tuned the mobile phlebotomists. Because NovoPath uses discrete data elements, we will be writing reports that will allow us to evaluate the most common tests by client as well as to provide value added services to the clients.

28 Lean is used to remove waste and standardize processes. The NovoPath Lean Module helps with tracking a number of steps. The uses of bar-coding and specimen tracking helped us to lean the processes. The NovoPath system is modular and by combining modules and being creative, it can help you determine bottlenecks, track people, materials and specimens to improve flow. Using discrete data elements to produce reports, helps a lab to provide value added services at no additional cost.

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