Quality Process Changes to Improve
Laboratory Services for Cancer Center
Patients
Department of Clinical Laboratories and
Cancer Center Services
Laboratory:
J .Molnar, C. Blakemore, A. Paglin, M.Rider, T. Lamb, B. Binford,
C. Jarosz, C. Shipp, S. Kahn
Cancer Center:
B. Buturusis, P. Stiff
Confidential: For Quality Improvement Purposes Only
Opportunity
Laboratory testing for Cancer Center patients was
performed at two locations: Loyola Outpatient
Center (LOC) for hematology and the hospital
Core Lab (Core) for all other testing. All samples
drawn in the Cancer Center were split and sent to
the two locations. Staffing for the LOC lab was
rotated from the Core lab to cover the limited
schedule of operations. Instrumentation and
reagents were also duplicated at both sites.
.
Confidential: For Quality Improvement Purposes Only
Opportunity and Solutions
The consolidation of the two laboratories,
LOC and Core, would maximize resources,
decrease turn-around-time for testing and
provide expanded hours of service for
Cancer Center laboratory testing.
Quality service for Cancer Center patients
Confidential: For Quality Improvement Purposes Only
Goals
Consolidate testing for Cancer Center patients
to one location (Core)
Maximize the efficiency and productivity of
Core and LOC staff
Provide a seamless transition in service for all
Clinicians and patients
Confidential: For Quality Improvement Purposes Only
Goals continued
Decrease turn-around-time for all Cancer
Center hematology testing
Provide expanded hours of service for
Cancer Center patients
Generate cost savings by eliminating the
duplication of services
Confidential: For Quality Improvement Purposes Only
Target
Turn-around-time (TAT) for Cancer Center
results not to exceed current TAT of 53.5
minutes
Stretch Goal: Reduce current TAT by
15%
Confidential: For Quality Improvement Purposes Only
Pre-Consolidation
LOC staffed with
3 FTEs pulled
from the Core
Lab
Patient samples collected in
the Cancer Center
Personnel
Duplicate testing
and instruments
in Core Lab
Samples to
LOC and
Core
CBC in LOC
Shared samples
sent to Core Lab
for testing of retic
CORE Lab
24/7
Retic sent to
Core
CBC to Core After
1700 M-F
Limited hours of
operation M-F
and no weekend
coverage
Testing performed at
both sites with
duplication of
personnel and
equipment
All patient samples
sent to 2 locations for
testing
Confidential: For Quality Improvement Purposes Only
Implementation
Reduced processes in Cancer Center
Phlebotomy by forwarding all samples
directly to the Core Lab
Combined LOC and Core staff to add
flexibility and improve productivity
Implemented triage of Cancer Center
specimens for immediate receipt and
analysis in the Core Lab
Confidential: For Quality Improvement Purposes Only
Post-Consolidation
Patient samples collected in the
Cancer Center
Samples to
Core
Maximized
staffing in
one testing
area
Samples are sent
to 1 location for
testing
CORE Lab
24/7
All samples sent
directly to the Core
for testing.
Maximized efficiency
and productivity of the
Core staff and
instrumentation
Personnel
Confidential: For Quality Improvement Purposes Only
Confidential: For Quality Improvement Purposes Only
Analysis
Turn-around-time decreased from a mean of
53.5 minutes to 37.9 minutes.
TAT reduced by 25%, thus exceeding the
original goal by 10%.
Eliminated duplicate services resulting in a
cost savings of $37,000.
Confidential: For Quality Improvement Purposes Only
Next Steps
Develop quarterly audits of TAT for Cancer
Center patients
Implement auto verification for Cancer
Center samples to enhance overall patient
satisfaction (Decrease TAT for results)
Confidential: For Quality Improvement Purposes Only