Agenda

One dominant trend in both clinical laboratory and anatomic pathology services is the goal of improving the utilization of lab tests by physicians. A task force of advanced thinkers has assembled a new document, published by CLSI as GP 49.

This guide is an effective “how-to” when planning a lab test utilization project. It provides a step-by-step path for designing the program, winning collaboration with physicians, pharmacy, and hospital administration, and implementing the program. This session is an intimate workshop that allows attendees to have close interaction with the speaker: Gary W. Procop, M.D.

There is much to be learned from one of the nation’s largest and most complex reference laboratories. In this session, there will be discussion about the common systems and tools that were developed and are now used across all lab departments and all laboratory sites.

Special emphasis was given on training the lab staff in the most practical methods and IT capabilities that would help them think systemically about corrective actions and how to address the root causes of nonconforming events. This was an enterprise-wide initiative, implemented one division at a time. The goal was to shift from applying band-aids to identified issues and instead to help staff think systemically.

ARUP Laboratories is CAP 15189 accredited, and the ISO audits looked at the best-in-class projects within the lab and were used to help empower the staff to take actions that would address systemic issues.

This important presentation on the makeover of a microbiology laboratory has several useful elements. Among the challenges confronting the laboratory at University Health Services was capacity constraints in microbiology, along with the fact that more than 50 percent of microbiology staff is eligible for retirement. This presentation will share how the microbiology lab’s workflow was redesigned to incorporate both Lean principles and new automation.

To demonstrate to hospital administration the value of automation, a demonstration of equipment was arranged. Related to the microbiology service makeover was the inclusion of a full-time pharmacist as part of the team. You will hear how these changes made positive impacts on therapy.

Among the achievements of this microbiology laboratory makeover is the fact that it operates on a 20-hour/7-day basis and has contributed to a reduction of one full day for the average length of stay for patients.

During this special breakout session, Patrick Gontard will drill down into several proven approaches to boost laboratory productivity, reduce costs, and slash turnaround times. He will expand upon the information he provided during the morning’s general session.

Gontard has experience in managing clinical laboratories in countries located in Europe, the Middle East, and the Pacific Rim. His techniques and approaches have proven effective in a wide variety of laboratory settings and organizations. You’ll gain practical knowledge and specific techniques that you can use to obtain similar results in your own lab.

This is an excellent case study of how the Mayo Lab team solved the many problems associated with designing and constructing a new lab, while at the same time consolidating testing for many different sites into a single location. You will learn effective ways to design a lab using Lean methods and Value Stream mapping.

Effective project management and the most effective ways to integrate different labs into a single facility will be discussed. Helping lab staff deal with the changes and the new culture will also be addressed. One interesting element to be shared is how this project to design, build and occupy a new lab facility incorporated the greenfield attributes that are environmentally friendly. You will learn how the lab team started with a vacant lot and ended up with a multistory lab facility that now houses multiple lab divisions that were formerly operating from different locations.

Every lab would love to achieve the ideal of full inspection readiness. At ProMedica Laboratories, great strides have been made in preparing this multi-site laboratory organization for inspections.

Topics to be discussed include standardization across the different hospital and health system laboratory sites, effective multi-site management of these different laboratory facilities, and culture change involving staff to support the goal of inspection readiness. Included in the session will be a case study of the digitization of all documentation and checklists, in support of the standardization across all sites of test menus, instrumentation, and policies and procedures. This is essential knowledge for any lab professional pursuing the goal of a fully inspection-ready laboratory.

Each year, Luci Berte is one of the more popular speakers at Lab Quality Confab. She has an international reputation for her expertise in laboratory processes, quality control, quality assurance, and similar activities associated with measuring and managing a lab’s quality.

In this session, Berte will address why the foundation of a lab’s quality is centered upon “process.” You will learn to understand how each individual process in the journey of a specimen from the physician’s test order to the reporting of results and the lab’s quality control activities impacts the lab’s quality.

The importance of “process” in support of your lab’s continuous improvement will be discussed and demonstrated. Most importantly, you will learn now to articulate and demonstrate why investment and resources devoted to quality control activities directly can contribute to reduced cost because systemic errors are found and eliminated much sooner than is typical.

One approach to sustain the culture of continuous improvement at the laboratory division of Henry Ford Health was the development of a modified kaizen approach. You will learn how, within the lab’s mature culture of continuous improvement, the development of team-based kaizen events specifically designed to engage frontline staff was used to generate momentum and enthusiasm. By design, a kaizen event is a quick team effort that focuses on specific improvement opportunities with implementation and metrics to guide the outcomes.

This session will share the lessons learned from kaizen process failures as a way to illustrate opportunities for effective staff engagement. More significantly, the lab’s structured kaizen process will be explained to show how it was elevated from a simple tool, to a system that allows the elimination of prioritized issues, thus supporting continuous improvement.

Here is an interesting microbiology laboratory case study involving a hospital in a smaller community that also serves 12 physician offices. Recognizing the need to support an effective antimicrobial stewardship program, the microbiology team at Appalachian Regional Healthcare System developed a comprehensive plan for the microbiology laboratory.

Using Lean and process redesign techniques, the lab team implemented a mass spectrometry automation system as the first stage. In the second stage the microbiology team implemented the FilmArray system from BioFire. Collectively these changes enabled the microbiology laboratory to contribute to a substantial reduction in patient length of stay.

One measured outcome was a reduction from four to seven days to achieve identification and sensitivity of infectious agents, down to an average of two to two and a half days. Patient length of stay was reduced proportionally to this reduction in results reporting. You’ll hear how the lab team collaborated with physicians and administration to achieve these outcomes.

Clinical labs and pathology groups that are utilizing Lean and process improvement methods understand the importance of a goal and a work culture focused on zero defects via continuous improvement. The laboratory division at Henry Ford Health System has developed a deviation management system that engages lab staff in a positive and collaborative manner to attack defects of any type.

You’ll learn how this system identifies, trends, and prioritizes defects resolution. Staff engagement, motivation, and ongoing management will be shared. Specific ways to measure the cost of systemic errors and the cost of waste that is reduced or eliminated will be demonstrated. The emphasis of this system and this approach is empowerment of lab staff who are engaged and motivated to apply the principles of continuous improvement in ways that reduce cost, eliminate errors, and contribute to improved patient outcomes.

Lab Quality Confab is proud to present this case study from one of Portugal’s major clinical laboratory companies. The techniques of Lean, Six Sigma, and process improvement are being used globally by top-performing laboratories. Consequently, the Centro Medicina Laboratorial Germano de Souza will have many similarities to clinical labs in the United States. At the same time, member countries of the European Union are ahead of the United States in standardizing the accreditation of laboratories.

You’ll earn about the progressive successes of this lab during its eight-year journey with quality management methods. The issues of managing sophisticated laboratory automation, standardizing test menu and procedures across multiple lab sites, and building a culture of continuous improvement have all occurred with this laboratory. Hear about its successes, along with lessons learned. Metrics and outcomes will be shared to demonstrate the effectiveness of various quality improvement initiatives.

All hospital and health system laboratories share a common challenge in meeting and exceeding the expectations of physicians and nurses in their organizations’ emergency departments. At Dignity Health’s St. Joseph’s Hospital and Medical Center, the laboratory team embarked on an ambitious project to better meet and exceed the expectations of ED staff with the laboratory testing services it provides.

You’ll learn why the lab decided to use a real-time analytics solution, why administration provided the funding for that solution, and how its deployment enabled the lab team to then watch the specimens’ journey from test order to specimen collection to arrival in the lab and to reported results.

Interesting aspects to this case study are the fact that the lab provides phlebotomists in the emergency department, and uses the real-time analytics solution to improve staff scheduling while reducing overtime. The metrics that demonstrate the reduction in different sources of errors, the improvement in the quality of specimens collected and arriving in the lab, and the improvement in turnaround time by focusing on outliers will be provided.