Coagulation Workflow Define Measure Analyze Improve Control

1
Coagulation Workflow Define Measure Analyze
Improve Control

• Cherri Doud, Mary Capper, Joyce Sanderson,
• Karla Frink, Jennie Kingery,
• Pam Goldsmith, Karin Olson
• Hematology Laboratory

2
Define

• Problem
• Coagulation turnaround times were not being met.
• Goal
• Implement workflow changes in order to meet the
• turnaround time goal.

3
Measure

• Turnaround Time (TAT) Goal
• 80 of coagulation test results verified within
  1hour.
• Measure
• This goal was met only 87 of the time.

4
MEASURE
BEFORE
5
Analyze

• Lab redesign necessary with implementation of new
  hematology analyzers.
• Old routine of alternating BCS primary analyzer
  inefficient with new lab layout, contributing to
  poor TATs.

6
ANALYZE
Before Changes
7
Improve - Redesigned workcell
8
IMPROVE
Post-Sysmex Implementation
9
BCS Analyzer
10
Coag/UA Workcell
11
Coag Processing
12
Coag/HT
13
Brainstorming
14
Improve

• Changes
• Designate BCS 1 as primary coagulation analyzer.
• Designate BCS 2 as Hemostasis/Thrombosis (HT)
  analyzer.
• Perform maintenance and QC on both instruments on
  3rd shift both ready for AM phlebotomy load.
• Create flowcharts to outline process for staff.

15
IMPROVE
AFTER Meeting TAT Goal 95 of time.
16
Control

• Continue to measure and review TATs daily.
• Re-evaluate processes as the Hematology redesign
  and Sysmex implementation continues. More changes
  when the dust settles? Where will POC testing
  land?

17
Control

• Remaining Items to Consider
• Are there any BCS software updates that will help
  us?
• New Hepzyme procedure coming less disruptive to
  workflow.
• Develop a Learn at Lunch session Top 10 Tips
  for Running the BCS Effectively?
• Can we print a log of the overdue tests?

18
Conclusion

• Changes to workflow worked! TAT goal being met
  gt90 of the time.
• Project has been in a holding pattern because of
  Sysmex.
• New testing/instrumentation on the horizon
• TEG (Thromboelastography)
• IFOBT (Immunoassay Fecal Occult Blood Test)
• Stay tuned for future developments