2.50
Hdl Handle:
http://hdl.handle.net/10755/162504
Type:
Presentation
Title:
Six Sigma Emergency Department/Laboratory Process Improvements
Abstract:
Six Sigma Emergency Department/Laboratory Process Improvements
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Wiley, Karen K., RN MSN, CEN
P.I. Institution Name:Alegent Immanuel Medical Center
Title:Staff Nurse
Contact Address:6901 No. 72nd St., Omaha, NE, 68122
Contact Telephone:402-572-2225
[Leadership Conference Poster Presentation] Purpose: Patients seeking emergency department services require life-saving care. Waiting for interventions including medications, radiologic examination, and blood work, delay diagnosis and treatment which affect quality patient care and patient outcomes. Automated Basic Metabolic (BMP) and Troponin tests did not meet laboratory or emergency department expectations of 45 minutes from order entry to result. The purpose of this Six Sigma project is to improve patient care and emergency department throughput by reducing tests turn-around-time.

Design: A quantitative process improvement study utilizing Six Sigma methodology was implemented to eliminate defects and reduce variation in our process.

Setting: A 35,000 visit a year ED, level II Midwest Medical Center.

Participants/Subjects: This project involved ED, laboratory managers, medical and support staff. The subjects included all patients requiring a BMP and Troponin testing in a 20-bed ED.

Methods: A collaborative effort between the laboratory and emergency department utilized the Six Sigma structured process to define the problem, measure, analyze the data, and help create innovative improvements to control the variables. The team identified the following metrics to measure success: 90% of blood specimens will be in the laboratory within 20 minutes of order; <2% missed collection by staff; and specimen rejection rate <1%. The consistency in turn-around-time (TAT) was identified as 90% of the results will be reported within 45 minutes of order and 1% > 70 minutes. Baseline compliance to 45 minute TAT was established in the Measure phase. A one week data collection period in June 2007 yielded a 79.9% compliance rate.
Improvements initiated were yellow pneumatic tubes for easy identification of emergency department stat specimens. Standardization of emergency department telephones with "Hot Keys" for one button department notification to ease communication and reduce movement. An educational program was developed to prevent hemolysis, establish best practice and reduce errors for Registered Nurse draws.

Results: During July 2007 the compliance to the goal was 74.4% of the results were reported within 45 minutes of order. The average TAT was 38 minutes. Compared to May 2008 the compliance to goal was 86.7% and the average TAT was 32 minutes from order to result. From July 2007 to May 2008 the average TAT decreased by 6 minutes. The reduced turn-around-time benefits the patient through timely diagnosis and treatment.

Recommendations: The focus of Six Sigma is putting the customer first. The process was developed to eliminate and minimize special causes and minimize variation. Prior to Six Sigma there was no standardization of order entry, communication between the emergency department and the laboratory varied. Neither the Laboratory nor the ED could have achieved the results on their own. The educational program to prevent hemolysis created an awareness of how technique affected the integrity of the specimen. Six Sigma process can improve performance by controlling the variables and hardwiring the process. Delays in reporting were found to be failure to follow the process.
Future applications should explore how change in practice affects patient throughput from the ED to an inpatient bed.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSix Sigma Emergency Department/Laboratory Process Improvementsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162504-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Six Sigma Emergency Department/Laboratory Process Improvements</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wiley, Karen K., RN MSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Alegent Immanuel Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Staff Nurse</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">6901 No. 72nd St., Omaha, NE, 68122</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">402-572-2225</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">karenkwiley@cox.net</td></tr><tr><td colspan="2" class="item-abstract">[Leadership Conference Poster Presentation] Purpose: Patients seeking emergency department services require life-saving care. Waiting for interventions including medications, radiologic examination, and blood work, delay diagnosis and treatment which affect quality patient care and patient outcomes. Automated Basic Metabolic (BMP) and Troponin tests did not meet laboratory or emergency department expectations of 45 minutes from order entry to result. The purpose of this Six Sigma project is to improve patient care and emergency department throughput by reducing tests turn-around-time.<br/><br/>Design: A quantitative process improvement study utilizing Six Sigma methodology was implemented to eliminate defects and reduce variation in our process.<br/><br/>Setting: A 35,000 visit a year ED, level II Midwest Medical Center.<br/><br/>Participants/Subjects: This project involved ED, laboratory managers, medical and support staff. The subjects included all patients requiring a BMP and Troponin testing in a 20-bed ED.<br/><br/>Methods: A collaborative effort between the laboratory and emergency department utilized the Six Sigma structured process to define the problem, measure, analyze the data, and help create innovative improvements to control the variables. The team identified the following metrics to measure success: 90% of blood specimens will be in the laboratory within 20 minutes of order; &lt;2% missed collection by staff; and specimen rejection rate &lt;1%. The consistency in turn-around-time (TAT) was identified as 90% of the results will be reported within 45 minutes of order and 1% &gt; 70 minutes. Baseline compliance to 45 minute TAT was established in the Measure phase. A one week data collection period in June 2007 yielded a 79.9% compliance rate.<br/> Improvements initiated were yellow pneumatic tubes for easy identification of emergency department stat specimens. Standardization of emergency department telephones with &quot;Hot Keys&quot; for one button department notification to ease communication and reduce movement. An educational program was developed to prevent hemolysis, establish best practice and reduce errors for Registered Nurse draws.<br/><br/>Results: During July 2007 the compliance to the goal was 74.4% of the results were reported within 45 minutes of order. The average TAT was 38 minutes. Compared to May 2008 the compliance to goal was 86.7% and the average TAT was 32 minutes from order to result. From July 2007 to May 2008 the average TAT decreased by 6 minutes. The reduced turn-around-time benefits the patient through timely diagnosis and treatment.<br/><br/>Recommendations: The focus of Six Sigma is putting the customer first. The process was developed to eliminate and minimize special causes and minimize variation. Prior to Six Sigma there was no standardization of order entry, communication between the emergency department and the laboratory varied. Neither the Laboratory nor the ED could have achieved the results on their own. The educational program to prevent hemolysis created an awareness of how technique affected the integrity of the specimen. Six Sigma process can improve performance by controlling the variables and hardwiring the process. Delays in reporting were found to be failure to follow the process. <br/>Future applications should explore how change in practice affects patient throughput from the ED to an inpatient bed.</td></tr></table>en_GB
dc.date.available2011-10-27T10:29:19Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:19Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.