Healthcare Case Study – Optimizing Diagnostic Lab Efficiency

“Test in Question”

This study revolves around a diagnostic lab aiming to streamline its operations and enhance the overall efficiency of the testing process. One common challenge faced by diagnostic labs is the occurrence of “Test in Question” (TIQ) scenarios—instances where a laboratory test cannot be performed due to insufficient information or discrepancies in the test order or specimen labelling. The repercussions of TIQ instances include delayed test results, incomplete diagnostic information, and increased costs.

Approach

In the Define phase, we delved into the Voice of the Customer (VOC), identifying key stakeholders: Clients, Specimen Management, and Client Services. Clients sought timely and accurate testing with minimal disruption. Specimen Management focused on correct sample submissions, while Client Services aimed for an overall reduction in TIQs to optimize resources.

The Business highlighted concerns about stressed dissatisfaction caused by TIQs, impacting both clients and employees, emphasizing the need to reduce TIQs

The goal was to cut TIQs by 25%, addressing the average of 27 logged per day, from average monthly TIQ of 7% to 5.2%, excluding those raised in error. This aligned with our mission to enhance efficiency and satisfaction within the TIQ process.

In the Measure phase, strategy was twofold. First, focused on retrospective data collection, honing in on specific aspects crucial to understanding TIQ patterns. This involved analyzing historical TIQs linked to Reports, with a specific emphasis on accounts associated with high TIQ volumes. Additionally, sought to uncover the types and quantities of TIQs generated by individual accounts, providing a granular view of the problem landscape.

By delving into the historical data and pinpointing high-TIQ-generating accounts, the aim was to identify patterns and trends contributing to the TIQ influx. This strategic approach allowed the team to gather deeper insights, paving the way for targeted interventions in subsequent phases.

In the Analyze phase, the team leveraged the most recent TIQ summary and detailed reports to conduct a comprehensive examination of the problem. Employing tools such as Pareto charts facilitated a visual representation of the key contributing factors. Additionally, collaborative client meetings were convened to gain a deeper understanding of the issues encountered at the client’s end.

The analysis revealed several top causes behind the TIQs. These included insufficient sample quantity, unsuitable specimens, cases where no sample was received, instances where the test was not administered, and challenges associated with the absence of a standard test code.

During the Improve phase, the team proposed short-term and long-term solutions. Initiatives included training partner clients on TIQ processes, implementing monthly dashboard reporting, simplifying collection and documentation, encouraging clients to note changes on manifests, and advocating for standardized coding. These measures aimed to enhance efficiency and address challenges identified in the Analyze phase.

Control measures to sustain improvements were implemented. This included sales involvement was integrated for corrective actions and swift resolutions. Additionally, monthly reporting on key parameters and targeted client visits, especially for repeat offenders, were implemented to maintain a proactive approach in managing and reducing TIQs effectively.

Conclusion: The project reached its desired goal, showcasing the team’s dedication and strategic problem-solving. The continuous improvement journey undertaken by the Diagnostic Lab exemplifies the power of a well-structured DMAIC approach in overcoming challenges, enhancing customer satisfaction, and optimizing operational efficiency.

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