LOYOLA OUTPATIENT CENTERPHLEBOTOMY PATIENT

ENCOUNTER TIMES

“Hurry Up and Stick Me!”

Colleen Jarosz, Cathy Lai,Dan Post and Cathy Shipp

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%

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)

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

Solutions Implemented

• Identified 7:00am – 11:00am 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

Monthly Encounter Times Before Process ChangeM

inut

es

Encounter Time in Minutes Mean=13.58

Jan

04

Feb 0

4

Mar

04

Apr 0

4

May

04

Jun

04

Jul 0

4

Aug 0

4

Sep 0

4

11

12

13

14

15

16

17UCL

Mean

LCL

Monthly Encounter Times After Process Change

Min

utes

Encounter Time in Minutes New Mean=11.18

Jan

04

Feb 0

4

Mar

04

Apr 0

4

May

04

Jun

04

Jul 0

4

Aug 0

4

Sep 0

4

Oct 04

Nov 0

4

Dec 0

4

Jan

05

Feb 0

5

9

10

11

12

13

14

15

16

17UCL

Mean

LCL

UCL

Mean

LCL

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%!

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