Assignment Purpose: To identify a problem and develop and outcomes measure related to the problem Assignment Description Step One: The attachment is a scenario (The Belated Lab Test) of a virtu

Assignment Purpose: To identify a problem and develop and outcomes measure related to the problem Assignment Description Step One: The attachment is a scenario (The Belated Lab Test) of a virtu

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The Case of the Belated Lab Test Performance Improvement Team Exercise – Part 1 Introduction: College Community Hospital (CCH) is a 200 bed facility…

Assignment Purpose: To identify a problem and develop and outcomes measure related to the problem Assignment Description Step One: The attachment is a scenario (The Belated Lab Test) of a virtual PI team. You are the Health Information representative on this team. Carefully read the scenario Step Two:  a flow chart of this process needs to be completed, based on the dialog above. You may want to use small Post-It notes and write down each step and put them in order on the table in front of you. Next, read in your text about flowcharting (although you are not officially reading this chapter as part of your course work, it is an excellent reference and you will want to look at the example flow charts and the flowcharting symbols). Step Three: A formal problem statement that demonstrates what the team is addressing needs to be written. Step Four: Also, a specific measurable target for improvement should be written. Step Five: Summarize how Lean Six Sigma could help in this situation. Step Six: Submit the flowchart, problem statement, outcome target, and summary in one document. You should experiment with the flowcharting tools in Microsoft Word or PowerPoint! On the Insert tab, in the Illustrations group, click SmartArt. Use the various symbols provided for the flowchart. Helpful Hints:
Your problem statement should be customer focused, performance related, and stated in measurable terms. It should not imply a solution or a cause! Here is an example: “The current process for delivery, maintenance, storage and purchase of pump controllers is fragmented and inefficient. The result is wasted staff time, lack of available functioning equipment, inappropriate use of space and frustration on the part of the customers.” 
Your target for improvement must also be stated in measurable terms. For example: “Pump controllers will be available in proper working order within 10 minutes of request from the floor 95% of the time, beginning in November, 1992.


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The Case of the Belated Lab Test
Performance Improvement Team Exercise – Part 1
College Community Hospital (CCH) is a 200 bed facility oFering adult medical, surgical,
orthopedic and psychiatric care.
±he hospital provides a full range of diagnosTc and therapeuTc
services, including C± and MRI scanning and an eight bed intensive care unit.
±he 200 beds are
distributed over six inpaTent ²oors:

3A Acute Medicine

3B DiagnosTc Medicine

3C Intensive Care

4A Acute Psychiatry

4B Orthopedics

4C General Surgery
One year ago, faced with decreased paTent and staF saTsfacTon and rising costs, the management of
CCH adopted a ±otal Quality Management strategy.
±hey formed a Quality Council and chartered several
performance improvement projects.
Over a nine month period, projects were successfully completed in
Dietary, Nursing, Psychiatry, Materials Management, Pharmacy, Health InformaTon, and OutpaTent
±hey are now ready to begin a second round of projects.
One major source of dissaTsfacTon for physician and nursing staF has been slow turnaround Tme (±A±)
for laboratory tests.
±he lab performs about 3000 blood tests per week, the most common being CBC
(complete blood count), serum electrolytes (sodium, potassium, chloride and CO2), BUN, a kidney
funcTon test, and blood sugar.
Given the high level of complaints about slow lab test turnaround Tme, the Assistant Administrator
asked the Quality Council to iniTate a Performance Improvement project team to tackle the problem of
improving the number of tests completed within the hospital standard.
±he Quality Council agreed,
chartered a team, and asked the Assistant Administrator to act as ±eam Leader.
±he Assistant Administrator was familiar with ±otal Quality Management concepts and recruited a team,
including the ±ransport Supervisor, who had recently a³ended a class in PI Methods and ±ools.
When all
the recruiTng was done, the team members were:

Lo³a Paper, Assistant Administrator – ±eam Leader

±om ±ro³er, ±ransport Supervisor – Quality Advisor

Beth Harrast, ´loor Secretary, 3A

Harry Hiteck, Day Supervisor, Lab

Sam Drawit, Day Phlebotomist

Steve Spinner, Evening Lab ±ech

Cathy ´iler, Health InformaTon Management
Problems with scheduling the team meeTngs made in impossible to include a representaTve from the
lab night shiµ.

View the Answer

Now, it’s Tme for the Frst team meeTng.
Use your imaginaTon and “pretend” you are Cathy ±iler and
you are a²ending this meeTng!
NoTce the personaliTes and behavior of each of the di³erent team
———–CUR´AIN UP——————–
±irst, I want to thank you all for volunteering for this team.
I think we have….
Sam: (interrupTng)
I wouldn’t exactly say we all volunteered.
In fact, I’d say I was draµed.
Well, I suppose some of you were picked.
I asked the managers for people who really know what
goes on in this process.
So, you’re the experts.
And I asked Cathy ±iler to join us because she may be
able to help us to use the EHR system more e³ecTvely to help with this improvement opportunity.
I hope I can help!
Let me describe the problem.
We’re ge¶ng too many complaints about long turnaround Tmes
for lab tests – I mean from the Tme the physicians decide blood work is needed unTl the Tme the results
are available to them.
Harry helped me pull some data together that will give us a picture of how big the
problem is.
Everyone take a look at your handout.
´his bar chart shows the percent of tests that got done within the standard for the past year.
average is about 84%.
What are the standards, anyway?
No one ever told me there were standards.
I thought
everything was stat, stat, stat!
I know I spend a lot of Tme calling down to see when results are going to
be available.
Maybe that’s because we’re not making the standards all that oµen, whatever they are.

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