What a difference a day makes Small improvements at each step of the end to end pathway, as little as one hour or one day, support users to deliver effective MDTs, redesign outpatient clinics and improve the patient experience and outcomes (Jan 2011).

1. NHS
CANCER NHS Improvement
Diagnostics
DIAGNOSTICS
NHS Improvement - Diagnostics
HEART
What a difference a
LUNG day makes
“
Clinical excellence in partnership
STROKE with process excellence ”

2. What a difference a day makes
Pathology is core to the diagnosis and
monitoring of a very wide range of
conditions. Histopathology has a
particularly important role in the diagnosis
of cancer and in providing information on
which treatment decisions are based.
Improving Outcomes: A Strategy for
Cancer (January 2011) Annex C point 8
confirms current cancer waiting time
standards continue to be justified and
should be retained.
Small improvements at each step of the
end to end pathway, as little as one hour
or one day, support users to deliver
effective MDT’s, redesign outpatient clinics
and improve the patient experience and
outcomes
In 2006, the Review of Pathology Services
in England by Lord Carter endorsed Lean
as the method of choice for delivering
improvements in quality, safety and
productivity.
www.improvement.nhs.uk/diagnostics

3. What a difference a day makes
• Ensure clinical ownership and • Maximise the skills and potential
strategic leadership of staff
Clinical engagement and strategic Consider how job roles are structured.
executive support are essential to Increase BMS cut up and development
achieve and sustain any service of advanced and associate
improvement. practitioners. Do not design new roles
to support poor processes.
• Focus on the whole end to
end pathway • Optimise use of technology
Work with service users and staff across Using electronic ordering systems, voice
the whole pathway. Use whole activated and digital technology
pathway data to understand where solutions will improve safety and reduce
specimens, forms, blocks, slides and turnaround times.
reports are waiting.
• MDT meetings
• Improve flow of specimens – Schedule the pathology workload and
Adopt small batch size MDTs to coincide where possible to
Adopt small batch sizes throughout the ensure maximum impact. Use
entire pathway including booking in, technology such as video conferencing
the preparation room, laboratory, to support MDTs. Ensure pathology
reporting, typing and authorisation. input and make best use of pathology
Remove different work streams and staff time.
deal with everything on a first in, first
out basis. • Access to reports – optimise
technology
• Improve transport of specimens to Ensure electronic reporting is available
the laboratory – Keep samples and used by the clinicians who will act
moving on the result. Make your controlled
Ensure that transport of specimens and predictable turnaround time
from theatre, outpatient clinics and all information available to clinicians who
other users is rapid. Where possible can plan their patient care plans
send specimens to the laboratory as accordingly.
soon as they are taken. Avoid creating
batches of specimens in theatre fridges More information and supporting case
or outpatient departments. studies are available in “Learning how to
achieve a seven day turnaround time in
• Schedule tasks appropriately histopathology” at
Ensure daily through-the-day deliveries www.improvement.nhs.uk/publications
from source. Run continual cut up
sessions through the day. Pull work
through the laboratory and ensure
continuous transcription and
authorisation of reports.
www.improvement.nhs.uk/diagnostics

4. NHS
CANCER NHS Improvement
DIAGNOSTICS
HEART NHS Improvement
NHS Improvement over the last year, has worked with over 240 sites in
England to transform, deliver and build sustainable improvements across
the entire pathway of care in cancer, diagnostics, heart, lung and stroke
services. With a focus on quality, productivity and innovation, NHS
LUNG
Improvement works closely with the Department of Health with all work
aligned to national priorities.
With over ten years practical service improvement experience, NHS
Improvement aims to achieve sustainable effective pathways and systems,
share improvement resources and learning, increase impact and ensure
STROKE
value for money to improve the efficiency and quality of NHS services.
NHS Improvement
3rd Floor | St John’s House | East Street | Leicester | LE1 6NB
Telephone: 0116 222 5184 | Fax: 0116 222 5101
www.improvement.nhs.uk
Publication Ref: IMP/comms008 - January 2011
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Delivering tomorrow’s
improvement agenda
for the NHS