The Certified Process Excellence Leader (CPEL) program at Kettering Health Network aims to empower employees to continue improving processes. Since its inception, the program has helped the network implement innovative ways to make improvements.
Julia Landis, PharmD, BCPS, clinical pharmacist at Grandview Medical Center, led an initiative that significantly reduced MRSA PCR turnaround time.
Background: Methicillin-resistant staphylococcus aureus, or MRSA, is an infection-causing bacterium. Polymerase chain reaction, or PCR, is an analysis technique done upon receiving a patient specimen to obtain verified laboratory results. MRSA PCR turnaround time is critical for clinicians to know a patient’s infection status. The testing turnaround time helps to treat and provide care for patients in the most effective ways.
At the time of the project, the average turnaround time for MRSA PCR results at Grandview Medical Center was 31 hours. This resulted in increased days of treatment and hospital resources, including labs, nursing time, physician hours, and pharmacist monitoring time.
Objective: To reduce the average time from MRSA PCR scanned to results available and verified from 31 hours to 18 hours at Grandview Medical Center. Additional goals included reducing transport time from the Grandview Medical Center lab to the Kettering Medical Center lab from 13.7 hours to 10 hours and reducing turnaround time at the Kettering Medical Center lab from 17 hours to 8 hours.
Method: Landis led a multidisciplinary team in a Value Stream Analysis to determine the process areas to focus improvement efforts. Areas of opportunity were divided into three major categories: decreasing batches, courier systems, and the specimen receiving process.
Landis’ team implemented a cost-effective method for increasing the number of runs, or movement of specimens from one laboratory to the laboratory that performs the test. The goal was a reduction in overall turnaround time.
Likewise, the courier system previously followed a route that picked up specimens from Grandview Medical Center at approximately 8:30 a.m., which meant samples collected throughout the morning did not arrive at the testing lab until the following day. The pick-up time was moved from 8:30 a.m. to approximately 10-10:30 a.m. to arrive for testing around 11-11:30 a.m.
The Rapid Improvement Event (RIE) focused on the specimen receiving process at the testing laboratory. The RIE structure allowed laboratory team members to analyze the state of the current process, identify specific ideas for change, and implement the changes systematically.
One identified opportunity was in reducing unnecessary specimen movement. Previously, specimens were sorted twice, while waiting to be sent to the testing area. The team implemented a purple “KH MOL” label that introduced visual management and eliminated of one of these sorting steps, getting the specimen to the correct place faster.
There was also some opportunity for improvement in the time it took for the lab results to be verified by a technician after the specimen completed its cycle. Two alarms clocks were purchased to alert the lab technician when the specimens had completed their cycle, thus reducing wait time for verification of results.
Results: At the time of project completion, the turnaround time for the MRSA PCR test reduced from 31 hours to 24 hours, or a 22% improvement.
In addition, the transport time from the Grandview Medical Center lab to the Kettering Medical Center lab reduced from 13.7 hours to 9.4 hours, or a 32% improvement. The Kettering Medical Center laboratory turnaround time reduced from 17 hours to 13 hours, or a 23% improvement.