Specimen Processing and Handling: Being Lean is Phat. Urban Dictionary. Urban Dictionary (Definition #2) phat 1. Cool 2. Pretty Hot And Tempting

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1 Specimen Processing and Handling: Being Lean is Phat Nikola A. Baumann, PhD, DABCC Director, Central Clinical Laboratory and Central Processing Laboratory Mayo Clinic, Rochester, MN Urban Dictionary phat 1. Cool 2. Pretty Hot And Tempting now this hummer is phat Urban Dictionary (Definition #2) phat Phat does mean pretty hot and tempting. The problem with "phat" is that it is no longer in really. It has kind of phased out and is mostly used by wannabes, lowerclassmen in high school, or middle schoolers. It is now considered a slang faux pas. I wouldn't use it if I was you. 1

Cool 2. Pretty Hot And Tempting now this hummer is phat Urban Dictionary (Definition #2) phat Phat does mean pretty hot and tempting.

2 Specimen Processing and Handling: Lean is Pretty Hot and Tempting Nikola A. Baumann, PhD, DABCC Director, Central Clinical Laboratory and Central Processing Laboratory Mayo Clinic, Rochester, MN Disclosures Nikola Baumann, PhD has not received any formal training in Lean..ever Mayo Clinic, Rochester, MN Central Processing ~10,000 specimens/day ~7000 sorted and tested within Central Lab ~2000 aliquots Manually ordering of tests for BF/CSF ED work is prioritized during day shift 2

Disclosures Nikola Baumann, PhD has not received any formal training in Lean.

3 Obvious Pros to Automating Pre-analytical Processes Standardization Reduce human error Reduce batching Reduce workflow bottlenecks Load balancing across analyzers Allow technical people to do technical work Not-so-obvious Challenges to Automating Pre-analytical Processes Requires standardization in the pre-pre-analytical phase Batching may still occur Manual workflow still exists Workflow bottlenecks still exist Manual work-arounds pop up Lean Initiatives in the Central Processing (CP) Laboratory Developed by teams who do the work Ownership by lab staff Communicated Measured Communicated Measured Celebrated 3

pre-pre-analytical phase Batching may still occur Manual workflow still exists Workflow bottlenecks still exist Manual work-arounds pop up Lean

4 Process Improvement: Reduce Pre- Analytical Processing/Sorting Time Objective: To reduce the time from specimen received in lab to loading onto chemistry automation Methods: Value stream mapping current state 5S (Sort, Set in order, Shine, Standardize, Sustain) Metrics: Specimen sorting/processing time Specimen quality / daily volumes Staff satisfaction The Process Received in LIS Sorting to MPA Clotting (Serum) 4

state 5S (Sort, Set in order, Shine, Standardize, Sustain) Metrics: Specimen sorting/processing time

5 Sorting at point of receiving into MPA racks Racks are at several benches in CP Techs assess clotting, transfer to 2nd MPA rack Re-assess clotting Sorting at point of receiving into blocks MPA loader takes no more than 2 blocks to MPA bench Assessed for clotting and loaded into MPA rack Racks in cardboard boxes Abundance of supplies, many never used Extra racks in cardboard boxes under bench Racks in plastic bins Only needed racks stored below with dust covers Excess supplies put in storage Both MPAs have same setup 5

clotting and loaded into MPA rack Racks in cardboard boxes Abundance of supplies, many never used Extra racks in cardboard boxes

6 Maintenance supplies kept in various locations All maintenance supplies kept in clearly labeled tote that can be taken with the operator Supplies stored in drawers Staff filled supplies or did troubleshooting based on workflow and individual preference Supplies on open shelving Bus Route of checking/ restocking each MPA at certain time and troubleshooting Specimen Processing Time Before and After Process Improvements Lean Project Implemented Baseline: 14.2 ± 2.3 min After process improvement: 8.3 ± 1.7 min 6

Supplies on open shelving Bus Route of checking/ restocking each MPA at certain time and troubleshooting Specimen Processing

7 Other metrics: Sample Quality, Daily Volume, Staff Satisfaction Instrument errors/alarms for clotted or QNS samples remained constant Specimen volume increased by 24% Staff perception = reduced workload Conclusions Pick a process, any process Develop Lean teams staff led Communicate Process Ideas Rationale Measure Communicate and celebrate the success Thank You and Acknowledgements Sean Cedotal Education Lead Central Processing Laboratory Management Team Shannon Ostby, Josh Wees, Lori Jonsgaard, Chris Yoch, Mary Poncelet Lean team for MPA project: Cari Clayton (Lab Assistant), Judy Carlson (Lab Assistant), Tim Jennings (Lab Assistant), Travis Scott (Lab Assistant), 7

celebrate the success Thank You and Acknowledgements Sean Cedotal Education Lead Central Processing Laboratory Management Team Shannon Ostby, Josh Wees, Lori Jonsgaard,

BEGINNING THE LEAN IMPROVEMENT JOURNEY IN THE CLINICAL LABORATORY

BEGINNING THE LEAN IMPROVEMENT JOURNEY IN THE CLINICAL LABORATORY Author: Jason A. Coons, Program Manager, TechSolve Abstract Lean is an extremely powerful tool in identifying and eliminating waste. The