Innovations with "Best of Breed" Solutions:

Transcription

1 Innovations with "Best of Breed" Solutions: Valuable Lessons Learned by PinnacleHealth Laboratories Laboratory Executive War College May 14, 2008 Presented by: Judy Judith R. Darr, MS MT (ASCP) SH DLM Laboratory Administrative Director PinnacleHealth Hospitals Harrisburg, Pennsylvania 1

2 Consolidated and Automated Laboratory at Harrisburg Hospital Background PinnacleHealth was formed in 1996 by the union of 2 large city hospitals and the acquisition of a 3 rd suburban hospital in

3 PinnacleHealth Details PinnacleHealth maintains > 625 licensed beds ~ 5,000 employees Consists of 2 hospitals, several outpatient surgery centers, rehab hospital, and 6 outpatient phlebotomy sites Laboratory performs 2.5 million BILLABLE tests annually which is actually closer to 4 million TOTAL tests Laboratory supports an Outreach Program and a Kidney Transplant Program Major issues: Resulted in three problems that were opportunities for improvement: 1. 3 major laboratories split between 3 campuses 2. Growing workload that was unmanageable within allowable staffing levels 3. Aging staff and difficulty finding replacements 3

4 Issue resolutions: 1. New consolidated Laboratory based at Harrisburg Hospital 2. Automation 3. Aesthetic, ergonomic, and safety enhancements Consolidation of Laboratory Many plans were evaluated that included: 1. Remodeling current space 2. Constructing an off-site Laboratory 3. Constructing a new, on-site Laboratory 4

5 Overview of Decision for Onsite Laboratory Laboratory required 30,000 s.f. of space connected to main hospital at OR Specialized space required for the addition of productivity and quality enhancing AUTOMATION Productive, efficient Lab services required to meet demands for faster patient throughput Overview (cont d) The need to reduce reliance on scarce human resources; a total FTE reduction through attrition of ~ 14 FTEs predicted Improved productivity per FTE and reduced cost per test forecasted Estimated annual operations savings of >1 million by year 3. 5

6 Selling it to the Board The strategic plan developed by the Board was the perfect framework: - Optimize Quality and Safety - Be Preferred Health System of Physicians - Be recognized Employer of Choice - Advance Leadership through Clinical and Technological Innovation The Key to Success of the Entire Project was AUTOMATION! 6

7 Search for Best of Breed AUTOMATION The goal was to automate as many manual functions as possible. Because the largest volume of tests was performed in Chemistry and Hematology, we targeted those areas for the initial implementation that was to occur as soon as the new Lab opened. Search (cont d) Search Criteria and Questions: 1. Automate chemistry and hematology as fully as possible. 2. Do chemistry and hematology need to reside on the same platform? 3. Should we consider automating urinalysis and coagulation? 7

8 More Searching 4. Could/Would the automation vendor work with the construction team? 5. What was the $$$? We had an awful lot of homework and analysis to do! Where to Begin??? Read, read, read internet, journals, vendor information, etc. Talk, talk, talk to anyone who has implemented automation Visit, visit, visit as many automated sites and/or automation conferences as possible 8

9 Taking the Plunge!!! The following were determined after our exhaustive search: Beckman-Coulter s Total Lab Automation had the best soup to nuts menu for our chemistry and urinalysis testing. Plunge (cont d) Sysmex provided the best hematology platform for us; in addition, Sysmex distributed the Cellavision which has proven to be a valuable automated instrument for our Lab. 9

10 Plunge (cont d) Both Sysmex and Beckman-Coulter worked extensively with the construction team to optimally position their systems The costs for the automation lines were incorporated into the construction process Our Post Consolidation and Automation Success Story 10

11 120 Early AM TATs Mins Collect to result Mins Receive to result % Rptd by 8AM TAT in mins & % rptd by 8am Techs started to collect Relocation Implementation of Robotic Line new instruments instrument problems 0 Nov Dec Jan Feb Mar Apr May Jun Jan May Sep Oct Nov Dec Jan Mar May Jul Sep Nov Jan Sept Months TATs for ED Patient Testing The median TAT for ED Lab specimens decreased by 17 minutes! Pre-Consolidation and Automation ED BMP TAT from receipt to result = 54 minutes Post-Consolidation and Automation ED BMP TAT from receipt to result = 32 minutes 11

12 Other Positive Aspects Increased test volume by 11% without adding staff Increased productivity index from 107.3% to 124.8% Witnessed the attrition of 12 FTEs within 2 years of implementation Improved staff safety Improved patient safety Increased throughput TAT consistency Eliminated the need for staff to search though thousands of specimens for an add-on (-1 FTE) Laboratory joined with hospital OR at FS room a great physician pleaser The Future Increase the use of Collection Manager throughout the hospital(s) Automate coagulation Automate urine differentials Automate Blood Bank, Microbiology, and Tissue Pathology to a further degree 12

13 Questions??? Thank you for your participation! 13