LOYOLA OUTPATIENT CENTER PHLEBOTOMY PATIENT ENCOUNTER TIMES

1
LOYOLA OUTPATIENT CENTERPHLEBOTOMY
PATIENTENCOUNTER TIMESHurry 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 700am 1100am 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 Mean13.58
17
UCL
16
15
14
Minutes
Mean
13
12
11
LCL
Jul 04
Jan 04
Feb 04
Mar 04
Apr 04
Jun 04
Aug 04
Sep 04
May 04
7
Monthly Encounter Times After Process Change
Encounter Time in Minutes New Mean11.18
17
UCL
16
15
14
Mean
UCL
Minutes
13
12
Mean
11
LCL
10
9
LCL
Jul 04
Jan 04
Feb 04
Mar 04
Apr 04
Jun 04
Oct 04
Jan 05
Feb 05
May 04
Aug 04
Sep 04
Nov 04
Dec 04
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