Chap 2: Optimizing Laboratory Workflow and Performance Flashcards
Components of workflow
- Pre-analytic
- Analytic
- Post-analytic
Path of the workflow
- The patient
- Test selection
- Sample collection
- Sample transport
- Report creation
- Report transport
What should be considered in the entire process?
- Beginning (sample collection)
- End (reporting and saving of results)
- All processes in between
True or False: Laboratory testing process cannot vary from one facility to another
False
Steps in Laboratory Testing process
- Testing phase
- Pre-analysis
- Analysis
- Post-analysis - Role
- Physician
- Laboratory - Technology
- Pre-analytic work cell
- Analyzer
- Analytic work cell
A prerequisite to any performance optimization strategy
Understanding the workflow
Issues to consider when auditing operations
- Test ordering – where are orders placed?
- Sample collection – who collects the samples?
- Transportation – how are samples delivered?
- Sample receipt – is there a central receiving area?
- Sample processing – are samples centrifuged centrally or in distributed locations?
- Testing – how many workstations are used?
- Reporting – how many results reported?
Techniques to Collect Workflow Data
- Sample and Test Mapping
- Tube analysis
- Workstation Analysis
- Test ordering patterns / interviews
- Task mapping
It is a technique used to analyze the distribution of samples and tests overtime
Sample and Test Mapping
Daily and hour tests
Day Interval
batched tests
Week interval
Goals of Sample and Test Mapping
- identify overall workload patterns to assess where resources are matched to the needs.
- performance indicators (TAT) can be improved
Use to compare or check the past to present results
delta checks
automations can reduce labor but redesigning workflow is cheaper and more efficient
Tube Labor
Tube labor includes
- sorting & centrifuging
- Aliquoting
- Racking
- Unracking
- Loading
- Loading and Unloading of samples of analyzers
- Retrieving tubes for add-on tests
- Performing manual dilutions/reruns
- Storing tubes
Tube analysis
- # of containers other than tubes
- # of reruns needed as the results of instrument flags/laboratory policies
True or False: Redesigning the workflow is less expensive and more efficient
True
Goals of Workstation analysis
- Instrument audit (LIS)
- Test Menu
- Processing mode & Load Balancing
- Interviews
- Task Mapping
It is a test-based system used to perform specific % of test per hour and they are irrespective of how many tests are ordered.
Chemistry analyzers
True or False: Test menu is used if a test is performed only once or twice a week.
True
Test Menu requirements
- Considerable equipment
- Training
- Labor Input
then Send it to the Reference Laboratory
An analyzer that cannot be interrupted during operation
Batch analyzer
It can accommodate emergency sample anytime
Random Access (Stat Sample)
It is facilitated by load balancing (technique that distributes the work evenly) & (spreads testing over a longer period to better match the instrument)
Continuous Sample processing (Mixed Sample)
A fixed # of samples w/ scheduled day & time of test run
Batch Sample (Routine Sample)
It provides an opportunity for the staff to participate in analyzing workflow and
improving performance and identifies the issues that would not be readily apparent from the data collection
Test ordering patterns / interviews
It involves processing special requests such as: troubleshooting incorrect orders, unacceptable samples, and misaligned barcode labels
Orders for add-on tests
interviews are particularly valuable to understand what
occurs outside the laboratory
Computer-generated orders
Term “Statim” or immediately, perform the test immediately
STAT
This should be an ongoing activity where this is undertaken whenever contemplating adding workstations, new technology, or any significant change, and Can be applied to any segment of the laboratory’s workflow whether technical or clerical
Task mapping
letter A is the original workflow; B is the improved workflow. The Goal is to improve workflow.
Workflow analysis
identifies bottlenecks and impact of staffing
Workflow modeling
interferences can be drawn about more efficient processing and
testing
Workflow simulation
allows a person to analyze the complex interrelationships to better predict the outcome of a given workflow design
Workflow modeling software
