Here is an example of what we do to develop labor standards that managers can meet, all the time. It\'s not imposed--the managers agree. This creates strong accountability! Write to me at Paul.Fogel@ExecutiveInfoSystems.com with any questions or comments.

1. General Hospital
Chicago, Illinois
Laboratory
Executive Information Systems, Inc., Lake Oswego, Oregon
November 3, 2009

2. General Hospital
Chicago, Illinois
Table of Contents
Introduction
3
Project Scope
3
Productive Hours
4
Lab Volumes—All Areas
4
Changes to Future Operations
6
A Break with Conventional Budgeting
6
Laboratory Division
7
Regional Lab Volumes
7
Lab Operations— Medical Offices
12
Medical Offices Combined
13
Chicago 08-003-2324
17
Holyoke 08-004-2324
19
Division 08-006-2324
21
East Interstate 08-010-2324
23
Rockwood 08-014-2324
25
Central Interstate 08-016-2324
27
Cascade Park 08-019-2324
28
South Park 08-023-2324
30
Geneva 08-027-2324
32
Sunset 08-029-2324
33
Mt. Adams 08-034-2324
35
South Central 08-037-2324
36
Jefferson 08-039-2324
38
2009 Labor Standards
1

3. General Hospital
Chicago, Illinois
North Washington 08-041-2324
39
Skyline 08-043-2324
41
Adams 08-058-2324
43
Monroe 08-067-2324
45
Mother Joseph 08-073-2324
46
Orchards 08-082-2324
47
Interstate South 08-091-2324
49
Medical Office Administration and Support 08-005-6268
51
Mountain Park Lab and Blood Bank 01-031-2324
53
Cytogenetics 08-005-1952
57
Molecular 08-005-2325
59
Culture Bay/Shared Prep 08-005-2327
60
Cytology 08-005-2337
62
Microbiology 08-005-2350
64
Home Phlebotomy 08-005-2351
66
SAM/Toxicology 08-005-2352
68
Core Lab 08-005-2361
70
Histology 08-005-2362
73
Hematology (Wet/Dry) 08-005-2373
75
Regional Administration 08-005-6264
77
Client Services 08-005-6266
78
Clinical Lab Systems 08-005-6267
79
2009 Labor Standards
2

4. General Hospital
Chicago, Illinois
Introduction
This
document
serves
as
a
record
of
the
development
of
the
labor
standards
that
form
the
foundation
of
the
productivity
management
system
scheduled
for
implementation
in
2009.
In
the
tables
that
follow,
productive
labor
excludes
vacation,
sick,
and
holiday;
and
includes
any
overtime
and
temporary.
Each
of
the
cost
centers
functions
as
a
discreet
unit.
When
staff
work
in
an
area
other
than
their
home
cost
center,
the
hours
and
wages
are
properly
recorded
in
the
departments
in
which
they
work.
Project Scope
What
level
of
productivity
is
General
Hospital’s
current
operating
systems
capable
of
producing?
Given
the
same
management
structure
and
operating
framework,
given
the
same
constraints,
rules,
labor
agreements,
and
operating
procedures
as
exists
today,
what
is
the
best
performance
that
can
realistically
be
achieved
and
maintained?
The
most
grounded
and
provable
answer
to
this
question
comes
from
examining
historical
best
demonstrated
performance.
By
mining
each
unit’s
actual
operating
history,
labor
standards
can
be
derived
that
managers
will
consistently
meet.
Labor
standards
are
not
mere
targets,
stretch
goals,
or
best-­‐case
scenarios,
but
designed
to
produce
dependable,
reliable,
and
predictable
results
over
long
stretches
of
time.
The
labor
standards
outlined
and
agreed
upon
in
this
document
describe
what
can
realistically
be
achieved
now.
They
do
not
alter
how
work
is
currently
performed,
nor
do
they
change
General
Hospital’s
current
level
of
service,
clinical
quality,
or
lengths
of
stay.
These
labor
standards
work
within
the
current
structure,
and
do
not
describe
what
productivity
might
be
if
operations
were
recast
differently.
Reaching
for
a
new
level
of
efficiency,
one
that
has
never
been
achieved
at
General
Hospital,
would
necessarily
entail
a
set
of
management
interventions
that
change
how
daily
work
is
performed,
or
otherwise
alter
staff-­‐patient
ratios
without
harming
clinical
or
service
quality.
3

5. General Hospital
Chicago, Illinois
Productive Hours
In
the
department
analyses
that
follow,
hours
and
wages
are
productive,
not
paid.
They
do
not
include
nonproductive
hours
and
wages
(vacation,
sick,
non-­‐worked
holiday,
etc.).
Productive
hours
and
wages
do
include
travelers,
agency,
overtime,
double
time,
and
temporary,
along
with
straight
time.
Wages
exclude
fringe
benefits,
which
would
add
53%
to
2010’s
salaries
at
this
writing.
Lab Volumes—All Areas
After
reviewing
the
description
and
quantities
of
tests
performed,
volumes
were
divided
(source:
Ultra)
into
categories,
and
then
weighted
for
each
category.
Scores
were
assigned
based
on
hands-­‐on
“touch
time,”
not
wait
time
(technical
staff
can
perform
other
tests
or
move
on
to
other
activities
during
wait
times).
As
the
unit
of
measure
is
the
test
or
activity
performed,
average
batch
sizes
and
times
were
often
used
to
derive
individual
test
times
and
their
resulting
scores.
Ultra
captures
the
data
needed
going
forward,
but
some
of
the
fields
had
to
be
altered
for
individual
tests
to
reflect
the
degree
of
automation,
often
incorrectly
recorded
as
“manual.”
Lab
Clinical
Services
will
make
the
changes
so
that
Ultra
can
serve
as
a
reliable
data
source.
Automation
has
been
the
major
driver
of
productivity
improvement
in
the
lab
industry
in
the
last
few
years,
as
they
require
only
a
quarter
to
a
half
of
the
labor
of
a
comparable
manual
test.
We
want
to
preserve
the
distinction
between
manual
and
automated
tests,
not
only
for
accurate
productivity
capture,
but
to
preserve
an
incentive
to
reduce
costs
through
further
automation
in
the
future,
and
to
make
it
relatively
easy
to
calculate
the
return
on
investment
from
technological
improvements.
Laboratory
information
systems
are
composed
of
three
primary
subsystems:
GE-­‐ULTRA
for
general
lab,
CoPath+
for
pathology
and
cytology,
and
Hemocare
LifeLine
for
transfusion
medicine.
Upon
test
completion,
information
from
these
systems
is
sent
primarily
to
three
destinations—HealthConnect
electronic
medical
record,
the
data
warehouse,
and
the
Resolute
Billing
charge
capture
system.
The
aging
GE-­‐ULTRA
Laboratory
Information
System
will
be
replaced
in
the
next
few
years
with
Cerner,
which
will
require
reworking
of
the
process
used
to
generate
lab
workload
volumes
for
productivity
monitoring
purposes.
Weighted
values
in
the
following
table
were
determined
from
time
studies
General
Hospital
has
done
in
the
past,
and
by
reference
to
the
difference
in
labor
between
automated
and
manual
testing
from
College
of
American
Pathologist
(CAP)
values.
2009 Labor Standards
4

6. General Hospital
Chicago, Illinois
Test/Activity Weight Rationale
Automated
Test 1.0 This
is
the
basic
unit
of
measure.
Most
tests
are
automated,
and
regardless
of
the
type
of
test,
follow
the
same
basic
process.
These
equate
to
about
2-­‐3
minutes
each.
Demographics 1.0 Generally
takes
the
same
amount
of
time
to
prepare
as
an
automated
test.
Every
venipuncture
requires
a
demographic
profile
collection,
but
not
every
demographic
comes
with
a
venipuncture,
so
demographics
counted
separately.
These
equate
to
about
2-­‐3
minutes
each.
Manual
1
(partially
automated) 2.0 Some
tests
are
only
partially
automated.
This
category
captures
those
tests
that
have
only
some
aspects
of
the
process
automated.
These
tests
equate
to
4-­‐6
minutes
each.
Manual
2
(completely
manual) 4.0 A
routine
manual
test
takes
four
times
as
long
as
an
automated
test.
This
category
equates
to
8-­‐12
minutes
each.
Manual
3
(time-­‐consuming) 5.0 This
category
of
tests
equate
to
10-­‐15
minutes
each.
Manual
4
(highly
time-­‐consuming) 10.0 This
category
of
tests
take
20-­‐30
minutes
each.
Manual
5
(Cytogenetics) 24.0 Applies
to
Cytogenetics
only.
Manual
6
(Cytogenetics) 48.0 Applies
to
Cytogenetics
only.
Venipuncture
1 4.0 Draws
take
four
times
as
long
as
demographic
collections.
Every
venipuncture
requires
a
demographic
profile,
counted
separately.
Venipuncture
2 8.0 Baby
venipunctures,
capillaries,
fingersticks,
and
venous
blood
gasses
are
two
times
more
labor
intensive
than
routine
venipunctures.
Venipuncture
3 20.0 Equates
to
40-­‐60
minutes
to
cover
travel
time
for
home
phlebotomy.
Micro
1 2.0 Applies
to
microbiology
only.
Micro
2 4.0 Applies
to
microbiology
only.
Micro
3 8.0 Applies
to
microbiology
only.
Micro
4 10.0 Applies
to
microbiology
only.
Micro
5 12.0 Applies
to
microbiology
only.
Micro
6 14.0 Applies
to
microbiology
only.
Cytogenetics
1 120.0 Applies
to
Cytogenetics
only;
a
highly
labor
intensive
category.
Cytogenetics
2 144.0 Applies
to
Cytogenetics
only;
the
second
highest
labor
intensity
category.
Cytogenetics
3 192.0 Applies
to
Cytogenetics
only;
the
highest
labor
intensity
category.
2009 Labor Standards
5

7. General Hospital
Chicago, Illinois
Test/Activity Weight Rationale
POC
prefix
(point
of
care
testing) 0.0 Point
of
Care
(POC)
testing
is
performed
on
the
floors
by
the
nursing
units.
Multiplying
by
zero
eliminates
the
count
from
lab
totals
without
altering
data
collection
for
statistics.
No
Workload
Unit 0.0 These
are
counts
of
various
activities
for
statistics,
not
tests.
Multiplying
by
zero
eliminates
the
count
from
lab
totals
without
altering
data
collection.
Changes to Future Operations
One
of
the
ground
rules
of
this
project
is
that
any
change
to
future
operations
would
entail
a
change
to
standard.
Having
a
foundation
of
standards
will
allow
us
to
add
or
subtract
as
operational
changes
occur,
not
just
at
budget
time,
but
throughout
the
year.
It
will
also
allow
senior
management
to
make
a
fully
informed
decision
before
deciding
to
alter
operations.
The
standards
we’ve
worked
out
are
appropriate
for
current
operations
only.
Laboratory
practice
will
not
stand
still,
and
the
technology
is
changing
rapidly.
The
conversion
to
automation
will
change
the
way
work
is
done,
and
we’ll
need
to
account
for
this
in
the
revised
standard.
A
pattern
of
improving
productivity
with
growing
volume
across
many
areas
of
lab
implies
that
there
may
be
additional
capacity
in
some
areas
for
more
tests
at
little
or
no
additional
labor.
We
don’t
know
where
excess
capacity
currently
resides
in
the
system,
or
how
much
in
future
savings
that
might
represent.
A
strong
incentive
plan
would
encourage
managers
to
take
on
additional
testing
without
additional
labor
in
those
departments
where
productivity
improvement
is
possible.
A Break with Conventional Budgeting
The
new
productivity
model
represents
a
departure
from
the
way
that
General
Hospital
has
traditionally
staffed
operating
departments.
The
traditional
model
projects
laboratory
demand
based
on
demographics
and
utilization
trends,
and
the
departments
are
then
staffed
to
projected
demand.
In
some
cases,
departments
are
staffed
based
on
what
they
were
budgeted
the
year
before.
In
the
new
model,
the
link
between
projected
and
actual
is
dissolved.
Instead
of
staffing
to
what
projections
say
laboratory
demand
will
be,
or
ought
to
be,
operating
managers
and
clinicians
will
now
staff
to
actual
demand.
More
volume
means
more
staff;
less
volume
means
less
staff.
Conventional
fixed
budgets,
unresponsive
to
testing
volume,
will
be
replaced
by
flexible
labor
standards.
Since
the
new
labor
standards
use
a
ratio—hours
per
unit—and
not
a
fixed
number
of
FTE,
managers
are
encouraged
to
vary
their
staffing
levels
with
volume,
provided
they
maintain
their
hours
per
unit
standard.
2009 Labor Standards
6

8. General Hospital
Chicago, Illinois
Laboratory Division
The
labs
are
comprised
of
twenty
labs
located
in
medical
offices
that
serve
the
region,
the
regional
lab
at
Airport
Way
that
perform
most
of
the
tests,
Mountain
Park
inpatient
lab
and
blood
bank,
and
administrative
departments
housed
at
Airport
Way,
with
a
total
of
about
410
FTE.
As
test
and
phlebotomy
volumes
are
consistently
weighted
across
all
departments
regardless
of
specialty,
the
entire
volume
for
the
region
will
be
counted
fairly
regardless
of
future
service
mix
changes,
and
will
automatically
adjust
for
each
department,
to
factor
out
the
productivity
effect
of
changing
test
and
draw
mixes.
Many
offices
extended
their
operating
hours
in
March
and
June
as
part
of
an
effort
to
relieve
after-­‐hours
patient
demand
at
the
urgent
care
centers.
The
number
of
patients
being
served
after
6:00pm
in
these
locations
is
quite
small.
Had
the
patient
load
per
hour
been
the
same
in
the
extended
hours
(6:00pm
to
8:15pm)
as
before
6:00pm,
hours
worked
per
test
would
be
unaffected
by
extended
operating
hours.
The
extra
volume
would
have
offset
the
extra
hours
to
leave
the
productivity
ratio
unaffected.
That
not
being
the
case,
extra
productive
hours
have
often
been
required
to
cover
the
extended
service
hours.
Since
the
effect
of
extended
hours
are
still
being
studied,
and
possibly
reversed,
the
labor
standards
for
the
Medical
Offices
are
presented
in
two
ways—one
standard
without
extended
hours,
and
one
with
extended
hours,
as
applicable.
If
General
Hospital
decides
to
return
to
pre-­‐March
operating
hours,
the
appropriate
labor
standard
can
then
be
used
as
displayed
on
those
department’s
analyses.
Regional Lab Volumes
Lab
volumes
have
been
growing
rapidly.
Weighted
volume
is
up
15%
from
2006.
While
Lab
Operations
(medical
office)
weighted
volumes
have
grown
by
only
5%
since
2006,
the
Regional
Lab
has
grown
by
21%,
and
Mountain
Park
by
13%.
2009 Labor Standards
7

9. General Hospital
Chicago, Illinois
Individual
departments
show
much
more
variation
in
volume.
Molecular
!"#$%&'"%()*& has
grown
37%
since
2007,
SAM/Toxicology
by
45%,
and
Core
Lab
by
24%
175,000
since
2006.
Other
departments’
volume
has
decreased
over
the
period,
150,000 such
as
Cytology
(down
22%
from
2006,
but
up
since
2007),
and
125,000 Hematology
(down
37%
but
about
to
double
their
volumes).
In
the
100,000 medical
offices,
Adams’s
total
weighted
volumes
have
jumped
23%,
and
Orchard’s
by
39%
(since
2007),
while
Cascade
Park
declined
7%,
Chicago
75,000
and
Interstate
South
were
down
14%,
North
Washington
and
Skyline
by
50,000 9%,
Jefferson
by
12%,
and
Mt.
Adams
by
4%
in
weighted
volumes
since
Weighted
25,000 Unweighted 2006.
0
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
2006A 2007 2008 2009A
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
mix
is
becoming
less
labor-­‐intensive
per
test.
!"#$%&'(")*+,-$ .'/*+,"0$!"#$ 12,,3-*4'$ 5+)"0$!"#$
2.40 2.40 2.40 2.40
2.20 2.20 2.20 2.20
2.00 2.00 2.00 2.00
Avg Weight
1.80 1.80 1.80 1.80
Avg Weight Avg Weight
1.60 1.60 4 Year Avg 1.60 1.60
1.40 Avg Weight 1.40 1.40 1.40 Avg Weight
1.20 4 Year Avg 1.20 1.20 1.20 4 Year Avg
1.00 1.00 1.00 1.00
2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A
Today,
average
intensities
for
Lab
Operations
are
even
with
their
2006
intensity,
Regional
Lab
has
decreased
by
just
1%,
and
Mountain
Park
is
down
by
5%
compared
to
2006.
This
reflects
increasing
automation
of
tests,
which
is
far
more
efficient.
In
total
the
entire
lab
division
service
intensity
is
down
by
3%
since
2006,
but
up
from
last
year.
After
a
rise
in
2007,
the
region’s
efficiency
in
hours
per
weighted
test
has
improved
ever
since.
In
many
cases,
the
various
labs
have
absorbed
growing
volumes
without
a
commensurate
increase
in
staff.
This
has
been
somewhat
offset
by
some
departments
maintaining
their
staffing
despite
declines
in
volumes.
Managers
may
not
have
known
the
actual
workload
and
would
not
have
been
effectively
able
to
vary
staffing
with
patient
demand.
2009 Labor Standards
8

10. General Hospital
Chicago, Illinois
!"#$%&'($&)**&+(,-./(0&1(%/%&& 1"/23&4$"0#5/,6(&!"#$%&
5.20 760,000
5.10 750,819
750,000 746,754
741,206
5.00 738,458
4.93 740,000
727,690
730,000
4.79
4.80
720,000
710,000
4.60 4.55
4.51 700,000
4.46
687,963
690,000
4.40
680,000
4.20 670,000
660,000
4.00 650,000
2006A 2007 2008 2009A Std (Ext Std (Not 2006A 2007 2008 2009A Std (Ext Std (Not
Hours) Ext Hrs) Hours) Ext Hrs)
Except
for
2006
(which
is
October
to
December
annualized)
the
lab
division
has
improved
it’s
productivity
in
each
successive
year.
Although
productive
hours
have
increased
3%
since
2007,
weighted
volumes
have
grown
16%,
producing
strong
productivity
gains.
Overall,
standard
with
current
hours
of
operation
(since
June
2009)
in
the
medical
offices
is
4.51
productive
hours
per
100
weighted
tests,
and
4.46
hours
per
100
weighted
tests
with
the
former
hours
of
operation.
The
latter
standard
of
4.46
is
directly
comparable
with
the
measurement
period
of
the
analysis.
Total
productive
hours
at
standard
(current
operating
hours)
are
4,065
hours
and
$189,000
less
than
2009,
and
12,361
hours
and
$367,000
with
the
former
hours
of
operation
at
the
medical
offices.
Dollars
exclude
vacation,
sick,
holiday,
and
fringe
benefits,
which
would
add
another
51%
to
the
total.
The
Hematology
and
Molecular
departments
will
both
take
on
significant
new
volumes
at
very
little
incremental
labor
cost,
contributing
most
of
the
productivity
gains
seen
in
the
total
lab
results,
below.
More
detail
can
be
found
in
the
department
narratives
following
this
section.
• Analysis:
although
not
true
of
every
department,
overall,
lab
in
2009
is
at
it’s
most
efficient
level
of
the
four
years
studied.
Accordingly,
standards
for
many
department
preserve
what
they
have
achieved
to
date;
for
others,
standard
sets
them
to
a
higher
level
of
performance
achieved
before,
adjusted
for
any
non-­‐volume
related
changes
in
operations.
2009 Labor Standards
9

11. General Hospital
Chicago, Illinois
2009 Labor Standards
10

12. General Hospital
Chicago, Illinois
2009 Labor Standards
11

13. General Hospital
Chicago, Illinois
Lab Operations—
Medical Offices
Twenty
labs
located
in
medical
offices
around
the
region
collect
patient
samples
and
perform
tests.
Venipunctures
are
performed
by
dedicated
staff
in
each
medical
office.
This
comprises
about
85%
of
the
medical
office
workload,
with
the
remainder
devoted
to
testing,
performed
by
similarly
dedicated
staff.
Most
of
the
tests
are
sent
to
Airport
Way
(AWL)
lab,
where
the
workload
is
just
the
reverse—85%
of
its
work
involves
testing,
and
only
15%
is
draws.
Since
the
medical
offices
perform
few
tests
on
the
samples
they
draw,
the
number
of
tests
performed
and
venipuncture
volumes
do
not
correlate,
but
run
independently
of
each
other.
The
count
of
venipunctures
and
demographics
may
be
somewhat
inaccurate
from
a
billing
point
of
view.
A
small
fraction
of
patients
are
sometimes
charged
multiple
times
for
what
would
only
be
billed
once
outside
of
General
Hospital.
Multiple
tests
run
on
the
same
physician
order
triggers
one
venipuncture
and
one
demographic.
When
the
same
multiple
tests
are
ordered
from
several
physicians,
venipunctures
and
demographics
are
counted
for
each
physician
order
even
though
only
one
venipuncture
was
performed.
As
long
as
these
are
counted
consistently
(even
if
not
industry
standard),
the
counts
we
have
are
representative
of
actual
workload.
If
General
Hospital
converts
its
data
systems
to
capture
statistics
consistent
with
industry-­‐standard
billable
practices,
the
standard
can
be
recalibrated.
Since
the
medical
offices
have
two
separate
staffs
within
each
cost
center—phlebotomists
and
lab
technical
staff—and
since
each
group
is
driven
by
its
own
unit
of
measure,
we
created
a
productivity
analysis
that
is
multilayered,
yet
simple
and
analytical
enough
for
supervisors
to
find
useful
and
prescriptive.
The
analyses
following
show,
by
medical
office,
a
phlebotomy
section
(venipunctures
and
demographics),
a
testing
section
(weighted
tests),
and
the
total
for
both
groups.
A
labor
standard
applies
to
each
section,
and
productivity
reports
will
need
to
divide
each
cost
center
into
phlebotomy,
testing,
and
the
total.
Further,
to
maintain
a
tight
connection
between
people
and
the
jobs
they
perform,
hours
and
wages
for
managers,
supervisors,
and
schedulers
were
pulled
out
of
Lab
Operations,
who
often
support
multiple
sites,
but
have
all
their
time
coded
only
to
their
home
cost
center.
These
administrative
staff
will
form
their
own
cost
center,
to
be
called
Medical
Office
Administration
and
Support,
whose
workload
measure
is
the
unweighted
sum
of
volume
from
all
the
medical
offices.
As
the
volumes
are
consistently
weighted,
all
twenty
medical
offices
are
comparable
to
each
other
on
a
per-­‐unit
basis,
and
work
volumes
will
be
counted
fairly
regardless
of
future
service
mix
changes.
Many
offices
extended
their
operating
hours
in
March
and
June
as
part
of
an
effort
to
relieve
after-­‐hours
patient
demand
at
the
urgent
care
centers.
The
number
of
patients
being
served
after
6:00pm
in
these
locations
is
quite
small.
Had
the
patient
load
per
hour
been
the
same
in
the
extended
hours
(6:00pm
to
8:15pm)
as
before
6:00pm,
hours
worked
per
test
would
be
2009 Labor Standards
12

14. General Hospital
Chicago, Illinois
unaffected
by
extended
operating
hours.
The
extra
volume
would
have
offset
the
extra
hours
to
leave
the
productivity
ratio
unaffected.
That
not
being
the
case,
extra
productive
hours
have
often
been
required
to
cover
the
extended
service
hours.
Since
the
effect
of
extended
hours
are
still
being
studied,
and
possibly
reversed,
the
labor
standards
that
follow
are
presented
in
two
ways-­‐one
standard
without
extended
hours,
and
one
with
extended
hours,
as
applicable.
If
General
Hospital
decides
to
return
to
pre-­‐March
operating
hours,
the
appropriate
labor
standard
can
then
be
used
as
displayed
below.
Medical Offices Combined
This
analysis
rolls
up
all
twenty
medical
offices
(not
including
the
new
Murrayhill
clinic)
to
show
before
and
after
results.
Phlebotomy
and
Testing
volumes
have
been
picking
up
in
2009,
especially
in
the
medical
clinics.
Productive
hours
increased
faster
than
volumes
2006-­‐08,
producing
productivity
losses.
Performance
has
improved
in
2009—total
hours
are
up
less
than
1%,
but
volumes
are
up
4.2%
from
2008.
This
improvement
almost
wiped
out
the
productivity
losses
incurred
2006-­‐08,
making
overall
four-­‐year
productivity
performance
less
than
two
FTE
worth
to
the
negative.
Many
offices
extended
their
operating
hours
this
year
to
improve
patient
access.
Volumes
during
these
extended
hours
have
been
small,
producing
worse
productivity
in
those
hours
and
hurting
those
particular
departments.
A
few
clinics
reduced
their
operating
hours,
which
has
generally
improved
efficiency
by
seeing
the
same
number
of
patients
in
a
shorter
time.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
mix
is
becoming
less
labor-­‐
intensive
per
test.
3"4#1($.#& /"0#12(.#& !"#$%&'()*+$%&,-+(.&
2.50 2.50 2.50
2.30 2.30 2.30
2.10 2.10 2.10
1.90 1.90 1.90
Avg Weight Avg Weight Avg Weight
1.70 1.70 1.70
4 Year Avg 4 Year Avg 4 Year Avg
1.50 1.50 1.50
2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A
Average
intensities
for
Phlebotomy
and
Testing
combined
have
been
rising
in
the
Southeast
division
and
falling
in
the
by
the
same
amount.
In
total,
the
service
mix
in
2009
is
the
same
as
it
was
in
2006.
Since
the
continuation
of
the
extended
hours
project
is
still
unknown,
labor
standards
are
presented
in
two
ways—one
standard
with
the
current
operating
hours,
and
the
other
should
the
hours
of
operation
revert
to
where
they
were
before
March
2009.
The
total
effect
of
the
labor
standards
is
shown
on
the
following
graphs.
Overall,
the
standard
with
the
2009 Labor Standards
13

15. General Hospital
Chicago, Illinois
current
extended
hours
comes
out
to
the
same
as
that
which
the
clinics
in
total
are
operating
at
June
year
to
date.
However,
the
June
year
to
date
level
is
not
the
true
run
rate.
Since
many
clinics
extended
their
hours
in
March
or
June,
the
full
cost
presented
in
the
tables
below
has
not
yet
been
incurred.
Standard
for
current
operating
hours
does
represent
a
productivity
improvement.
How
much
are
these
extended
hours
costing?
Were
the
operating
hours
to
revert
to
their
pre-­‐March
times,
the
medical
offices
collectively
could
save
8,500
productive
hours
and
over
$200,000
in
productive
salaries.
As
shown
below,
hours
per
test
without
extended
hours
would
be
at
their
most
efficient
level.
!"#$%&'($&)**&+(,-./(0&1(%/%&& 1"/23&4$"0#5/,6(&!"#$%&
5.40 5.33 260,000
5.24
5.15 5.15 250,399 250,180
5.20 248,261
250,000
5.03 244,457
4.98 241,883
5.00
240,000
4.80 232,410
230,000
4.60
220,000
4.40
210,000
4.20
4.00 200,000
2006A 2007 2008 2009A Std (Ext Std (Not 2006A 2007 2008 2009A Std (Ext Std (Not
Hours) Ext Hrs) Hours) Ext Hrs)
2009 Labor Standards
14

16. General Hospital
Chicago, Illinois
The
clinic’s
relatively
small
volumes
do
not
help
efficiency.
Minimum
staffing
levels,
regardless
of
volumes,
are
almost
as
high
at
many
clinics
as
their
current
productive
hours.
The
graph
to
the
left
shows
the
relationship
between
size
and
efficiency.
The
correlation
is
only
9%,
meaning
that
as
volume
increases,
there
is
only
a
slight
relationship
towards
lower
hours
worked
per
test.
If
Monroe,
Mother
Joseph,
and
Central
Interstate
(the
smallest
clinics)
are
eliminated
from
the
sample,
the
correlation
actually
goes
the
other
way—a
slight
relationship
for
hours
per
unit
and
volume
to
increase
together.
• Analysis:
overall,
with
the
new
extended
hours
of
operation,
standard
is
the
same
as
June
2009
year
to
date.
However,
the
run
rate
for
many
medical
offices
since
March
2009
is
higher
than
shown
here,
to
cover
the
addi-­‐
tional
operating
hours
for
which
patient
volume
is
slight.
Year
to
date
figures
dilute
the
effect
on
productivity.
The
standard
without
extended
access
hours
would
save
8,500
productive
hours
and
$201,000
were
those
hours
to
be
rolled
back
to
former
hours
of
operation.
2009 Labor Standards
15

17. General Hospital
Chicago, Illinois
2009 Labor Standards
16

18. General Hospital
Chicago, Illinois
Chicago 08-003-2324
The
Chicago
building
(which
includes
other
services
besides
lab)
moved
from
a
primary
care
dominated
practice
to
specialty
care.
Some
primary
care
physicians
were
moved
out
to
other
locations
to
effect
the
change.
The
hours
of
operation
have
remained
the
same.
Phlebotomy
volumes
are
somewhat
lower
than
in
recent
years,
while
Testing
volumes
have
grown.
Productive
hours
have
held
fairly
steady.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
mix
is
becoming
less
labor-­‐
intensive
per
test.
./%(0"#"12& !(*#+,-& !"#$%&'()#&
2.50 2.30 2.50
2.30 2.10 2.30
2.10 2.10
1.90
1.90 1.90
1.70 Avg Weight 1.70 Avg Weight 1.70 Avg Weight
4 Year Avg 4 Year Avg 4 Year Avg
1.50 1.50 1.50
2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A
Phlebotomy
intensities
are
down
5%
in
2009
from
2006.
The
Testing
section
average
intensity
is
also
down
5%
from
2006,
and
close
to
it’s
four
year
average.
In
total,
Chicago’s
service
mix
today
is
5%
lower
than
it
was
in
2006.
For
the
Phlebotomy
section,
2007
hours
per
unit
was
chosen
as
the
appropriate
standard.
For
Testing,
we
used
2008
performance
as
the
labor
standard.
2009 Labor Standards
17

19. General Hospital
Chicago, Illinois
Action:
Phlebotomy-­‐the
variable
standard
is
4.77
productive
hours
and
$90
per
100
Weighted
Tests,
or
4,160
hours
per
year
(2
FTE),
whichever
is
greater.
Action:
Testing-­‐the
variable
standard
is
7.14
productive
hours
and
$182
per
100
Weighted
Tests,
or
1,664
hours
per
year
(o.8
FTE),
whichever
is
greater.
• Analysis:
overall,
standard
saves
569
productive
hours
and
$11,997
(at
June
year
to
date
actual
wages)
compared
to
2009
annualized.
2009 Labor Standards
18

20. General Hospital
Chicago, Illinois
Holyoke 08-004-2324
Hours
of
operation
were
increased
two
hours
per
day,
from
6:00pm
to
8:15pm,
effective
March
2,
2009.
Testing
and
draw
volumes
during
the
extended
hours
are
slight.
Although
it
would
be
less
expensive
to
add
two
hours
to
the
daily
shift
schedule,
there
are
minimum
time
commitments
when
adding
staff
of
one-­‐half
FTE.
Phlebotomy
staff
hours
were
boosted
one-­‐half
FTE
to
cover
the
extended
hours,
but
Testing
was
able
to
cover
by
staggering
shifts.
Phlebotomy
volume
has
been
steady
over
the
last
four
years,
but
Testing
volumes
have
grown
considerably.
Productive
hours
have
grown
steadily
in
both
Phlebotomy
and
Testing,
and,
despite
the
extended
operating
hours,
both
sections
are
running
more
efficiently
this
year
compared
to
last.
Phlebotomy’s
productivity
for
2009
in
the
table
below
understates
today’s
run
rate,
however,
as
the
extended
hours
took
effect
in
March,
and
2009
in
the
tables
below
are
annualized
from
June
year
to
date.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
mix
is
becoming
less
labor-­‐
intensive
per
test.
./%(0"#"12& !(*#+,-& !"#$%&'()#&
2.25 2.40 2.25
2.20 2.20
2.30
2.15 2.15
2.20
2.10 2.10
Avg Weight 2.10 Avg Weight Avg Weight
2.05 2.05
4 Year Avg 4 Year Avg 4 Year Avg
2.00 2.00 2.00
2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A
Phlebotomy
and
Testing
intensities
are
only
slightly
changed
today
from
where
they
were
in
2006,
but
below
the
peak
of
2007.
In
total,
Holyoke’s
service
mix
declined
1%
in
labor
intensity
in
2009
from
2006,
and
3%
less
in
2009
than
2007.
For
Phlebotomy,
2007
represented
the
most
efficient
performance
to
date
(2006
is
annualized
from
three
months,
and
may
be
an
anomaly),
and
was
used
for
the
labor
standard.
For
the
Testing
section,
2009
performance
was
used.
2009 Labor Standards
19

21. General Hospital
Chicago, Illinois
Action:
Phlebotomy—the
variable
standard
is
4.60
productive
hours
and
$85
per
100
Weighted
Tests,
or
4.24
hours
and
$78
without
extended
operating
hours.
Minimum
staffing
is
8,320
hours
per
year
(4
FTE).
Action:
Testing—the
variable
standard
is
9.28
productive
hours
and
$263
per
100
Weighted
Tests.
Minimum
staffing
is
4,160
hours
per
year
(2
FTE).
• Analysis:
overall,
standard
costs
804
productive
hours
and
$14,886
(at
June
year
to
date
actual
wages)
compared
to
2009
annualized,
due
to
extended
operating
hours.
Without
extended
hours,
standard
would
save
111
hours
and
$2,047
per
year
compared
to
2009
annualized.
2009 Labor Standards
20

22. General Hospital
Chicago, Illinois
Division 08-006-2324
Since
March
2009,
Division
has
been
open
an
extra
two
hours.
The
number
of
patients
served
after
6:00pm
is
quite
small.
While
the
Phlebotomy
section
is
not
affected,
extra
productive
hours
for
the
Testing
section
are
required
to
cover
the
extended
service
hours,
which
hurts
overall
hours
per
test
compared
to
past
years.
Phlebotomy
and
Testing
volumes
have
increased
over
the
last
few
years.
At
a
slightly
faster
pace,
productive
hours
for
both
sections
has
also
increased
over
the
years.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
mix
is
becoming
less
labor-­‐
intensive
per
test.
./%(0"#"12& !(*#+,-& !"#$%&'()#&
2.50 2.50 2.50
2.40 2.40 2.40
2.30 2.30 2.30
2.20 2.20 2.20
Avg Weight Avg Weight Avg Weight
2.10 2.10 2.10
4 Year Avg 4 Year Avg 4 Year Avg
2.00 2.00 2.00
2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A
Phlebotomy
intensities
fell
slightly
this
year,
reflecting
a
faster
increase
in
demographics
(weighted
at
1.0)
than
venipunctures
(weighted
at
4.0).
The
Testing
section
average
intensity
is
slightly
higher
in
2009
than
in
prior
years.
In
total,
Division’s
service
mix
is
slightly
less
labor-­‐intensive
in
2009
than
in
prior
years.
For
the
Phlebotomy
section,
we
used
2007
performance
for
the
standard.
For
Testing,
we
used
2007
hours
per
Weighted
Test,
and
added
two
hours
per
weekday
to
account
for
the
unproductive
extended
operating
hours.
2009 Labor Standards
21

23. General Hospital
Chicago, Illinois
Action:
Phlebotomy-­‐the
variable
standard
is
4.05
productive
hours
and
$76
per
100
Weighted
Tests,
or
4,160
hours
per
year
(2
FTE),
whichever
is
greater.
Action:
Testing-­‐the
variable
standard
is
12.17
productive
hours
and
$296
per
100
Weighted
Tests,
or
9.99
hours
and
$243
per
100
Weighted
Tests
without
extended
operating
hours.
Minimum
staffing
is
2,704
hours
per
year
(1.3
FTE).
• Analysis:
overall,
standard
for
current
hours
of
operation
saves
203
productive
hours
and
$3,464
(at
June
year
to
date
actual
wages)
compared
to
2009
annualized;
without
extended
hours,
standard
saves
723
hours
and
$16,122.
2009 Labor Standards
22

24. General Hospital
Chicago, Illinois
East Interstate 08-010-2324
Before
2008,
the
Interstate
campus
was
an
emergency
center,
open
at
all
hours.
Since
2008,
it
operates
7am
to
11pm
every
day.
There
were
no
other
changes
to
operations.
Phlebotomy
volumes
have
been
rising,
while
Testing
volume
is
steady
and
low.
The
Testing
section
has
increased
hours
without
extra
volume,
causing
a
productivity
loss.
Some
of
the
tech’s
time
probably
should
have
been
coded
to
Interstate
South
and
not
remained
in
this
cost
center,
so
2008
was
used
to
set
the
standard.
Still,
because
of
very
low
volumes
and
minimum
staffing,
the
Testing
section
will
always
suffer
from
relatively
low
productivity
compared
to
Interstate
South.
A
way
to
eliminate
this
problem
may
be
to
merge
all
the
testing
for
the
Interstate
campus
in
Interstate
South.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
mix
is
becoming
less
labor-­‐
intensive
per
test.
./%(0"#"12& !(*#+,-& !"#$%&'()#&
2.30 2.30 2.30
2.20 2.20 2.20
Avg Weight
2.10 2.10 4 Year Avg 2.10
2.00 Avg Weight 2.00 2.00 Avg Weight
4 Year Avg 4 Year Avg
1.90 1.90 1.90
2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A
Phlebotomy
intensities
have
been
steady
for
the
last
three
years,
and
the
Testing
section
service
mix
has
been
very
steady.
Virtually
all
the
tests
are
in
the
Manual
1
category.
The
vast
majority
of
work
is
in
Phlebotomy,
and
East
Interstate’s
total
service
mix
reflects
the
pattern
for
that
section.
The
Phlebotomy
standard
uses
2008
actual
performance.
Although
2009
hours
per
unit
have
been
lower,
it’s
the
result
of
some
phlebotomists
not
charging
their
hours
correctly
when
they
split
their
time
between
Interstate
South
and
East
Interstate.
2009 Labor Standards
23

25. General Hospital
Chicago, Illinois
Action:
Phlebotomy-­‐the
variable
standard
is
4.39
productive
hours
and
$78
per
100
Weighted
Tests,
or
8,320
hours
per
year
(4
FTE),
whichever
is
greater.
Action:
Testing-­‐the
variable
standard
is
75.07
productive
hours
and
$1,373
per
100
Weighted
Tests.
• Analysis:
standard
saves
hours
762
productive
hours
in
Testing,
but
adds
1,568
hours
in
Phlebotomy
compared
to
2009
annualized.
This
may
be
a
result
of
miscoded
hours
in
2009,
not
a
productivity
change.
2009 Labor Standards
24

26. General Hospital
Chicago, Illinois
Rockwood 08-014-2324
Hours
of
operation
were
increased
two
hours
per
day,
from
6:00pm
to
8:15pm,
effective
March
2,
2009.
Testing
and
draw
volumes
during
the
extended
hours
are
slight.
Rockwood
has
been
able
to
cover
the
extended
hours
by
staggering
shifts,
and
the
operation
continues
to
run
efficiently.
Phlebotomy
volumes
were
fairly
steady
2006-­‐08,
and
then
increased
this
year.
Testing
volumes
have
grown
throughout
the
four
year
period
in
the
analysis.
Productive
hours
grew
steadily
in
Phlebotomy,
and
then
declined
slightly,
producing
productivity
near
its
best.
While
Testing
productive
hours
have
grown,
volumes
have
grown
even
faster,
to
produce
the
best
productivity
of
the
four
years.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
mix
is
becoming
less
labor-­‐
intensive
per
test.
./%(0"#"12& !(*#+,-& !"#$%&'()#&
2.30 2.10 2.30
2.20 2.05 2.20
2.00
2.10 2.10
1.95
2.00 2.00
1.90
Avg Weight Avg Weight Avg Weight
1.90 1.85 1.90
4 Year Avg 4 Year Avg 4 Year Avg
1.80 1.80 1.80
2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A
Phlebotomy
intensity
in
2009
is
1%
higher
than
in
2006,
while
Testing
intensities
are
off
3%
from
where
they
were
in
2006.
In
total,
Rockwood’s
service
mix
in
2009
is
the
same
as
it
was
in
2006.
For
Phlebotomy
and
Testing,
2009
performance
represented
the
most
efficient
(or
very
close)
performance
to
date,
and
was
used
for
the
labor
standard.
2009 Labor Standards
25

27. General Hospital
Chicago, Illinois
Action:
Phlebotomy-­‐the
variable
standard
is
3.67
productive
hours
and
$67
per
100
Weighted
Tests,
or
7,280
hours
per
year
(3.5
FTE),
whichever
is
greater.
Action:
Testing-­‐the
variable
standard
is
8.48
productive
hours
and
$233
per
100
Weighted
Tests,
or
2,704
hours
per
year
(1.3
FTE),
whichever
is
greater.
• Analysis:
overall,
standard
is
the
same
as
2009,
the
most
efficient
of
the
four
years.
2009 Labor Standards
26

28. General Hospital
Chicago, Illinois
Central Interstate 08-016-2324
Before
2008,
the
Interstate
campus
was
an
emergency
center,
open
at
all
hours.
Since
2008,
it
operates
7am
to
11pm
every
day.
There
were
no
other
changes
to
operations.
Central
Interstate
has
no
testing
section.
Volumes
have
held
fairly
steady
in
Phlebotomy,
but
productive
hours
have
crept
up,
causing
a
productivity
loss.
Some
minor
amount
of
draws
are
done
for
research
nurses,
and
are
not
counted.
Bone
marrow
prep
work
applies
to
those
locations
in
which
specimens
are
collected,
but
we
had
difficulty
in
assigning
a
specific
location.
However,
at
least
95%
of
outpatient
bone
prep
is
done
at
Central
Interstate,
and
all
inpatient
bone
prep
is
done
at
Mountain
Park.
A
very
small
amount
of
bone
prep
is
done
at
Longview,
Skyline,
and
North
Washington.
For
data
collection
and
monitoring,
our
rule
is
that
all
outpatient
bone
prep
volume
will
be
assigned
to
Central
Interstate,
and
all
inpatient
work
assigned
to
Mountain
Park.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
!"#$%&'&()* means
that
the
testing
mix
is
becoming
less
labor-­‐intensive
per
test.
2.47
Phlebotomy
intensities
have
been
rising
slightly,
reflecting
a
small
2.45
decrease
in
demographics
(weighted
at
1.0)
compared
to
more
complex
2.43 draws
and
venipunctures.
2.41
The
standard
was
based
on
a
mix
of
2006-­‐07
performance.
2.39
Avg Weight
2.37 4 Year Avg
2.35
2006A 2007 2008 2009A
Action:
Phlebotomy-­‐the
variable
standard
is
5.00
productive
hours
and
$96
per
100
Weighted
Tests,
or
2,080
hours
per
year
(1
FTE),
whichever
is
greater.
• Analysis:
standard
saves
977
productive
hours
and
$18,849
(at
June
year
to
date
actual
wages)
compared
to
2009
annualized.
2009 Labor Standards
27

29. General Hospital
Chicago, Illinois
Cascade Park 08-019-2324
Hours
of
operation
decreased
two
hours
per
day,
from
8:15pm
to
6:00pm,
effective
March
2,
2009.
Productivity
has
improved
with
the
change.
There
were
no
other
changes
to
operations.
Phlebotomy
and
Testing
volumes
have
grown
slightly
over
the
last
few
years.
Productive
hours
in
2009
are
down
from
where
they
were
in
2006-­‐08
to
cover
the
reduced
operating
hours.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
mix
is
becoming
less
labor-­‐
intensive
per
test.
./%(0"#"12& !(*#+,-& !"#$%&'()#&
2.20 2.20 2.20
2.00 2.00 2.00
Avg Weight
1.80 1.80 4 Year Avg 1.80
1.60 Avg Weight 1.60 1.60 Avg Weight
4 Year Avg 4 Year Avg
1.40 1.40 1.40
2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A
Phlebotomy
intensities
are
about
even
today
from
where
they
were
in
2006.
The
Testing
section
average
intensity
has
dropped
9%
since
2006-­‐07.
In
total,
Cascade’s
service
mix
declined
2%
in
labor
intensity
in
2009
as
2006.
For
both
Phlebotomy
and
Testing
sections,
2009
represented
the
most
efficient
performance
to
date,
and
used
for
the
labor
standard.
2009 Labor Standards
28

30. General Hospital
Chicago, Illinois
Action:
Phlebotomy-­‐the
variable
standard
is
4.80
productive
hours
and
$90
per
100
Weighted
Tests,
or
10,400
hours
per
year
(5
FTE),
whichever
is
greater.
Action:
Testing-­‐the
variable
standard
is
9.27
productive
hours
and
$256
per
100
Weighted
Tests,
or
4,160
hours
per
year
(2
FTE),
whichever
is
greater.
• Analysis:
standard
is
even
with
2009
annualized
performance.
2009 Labor Standards
29

31. General Hospital
Chicago, Illinois
South Park 08-023-2324
In
mid-­‐2008,
this
location
closed
on
Sundays.
Productivity
was
somewhat
better
in
2007,
due
to
more
use
of
part-­‐time
employees.
Turnover
proved
to
be
a
problem
since
part-­‐timers
are
not
benefitted,
and
the
department
moved
to
more
32-­‐
hour
staff
at
full
benefits.
Turnover
was
reduced,
and
there
is
no
overtime
or
agency
used
anymore.
Phlebotomy
volumes
are
higher
than
in
recent
years,
while
Testing
volumes
have
diminished
from
their
peak
in
2007.
Productive
hours
overall
have
crept
up
a
bit
each
year.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
mix
is
becoming
less
labor-­‐
intensive
per
test.
./%(0"#"12& !(*#+,-& !"#$%&'()#&
2.30 2.10 2.30
2.00
2.10 2.10
1.90
1.90 1.80 1.90
1.70
1.70 Avg Weight Avg Weight 1.70 Avg Weight
4 Year Avg 1.60 4 Year Average 4 Year Avg
1.50 1.50 1.50
2006A 2007 2008 2009A 2006A 2007 2008 2009A 2006A 2007 2008 2009A
Phlebotomy
intensities
are
about
even
in
2009
compared
to
2006.
The
Testing
section
average
intensity
is
down
10%
from
2006,
as
the
proportion
of
automated
tests
has
increased
quickly.
In
total,
Longview’s
service
mix
today
is
about
the
same
as
in
2006.
For
both
the
Phlebotomy
and
Testings
sections,
2009
hours
per
unit
was
chosen
as
the
appropriate
standard.
2009 Labor Standards
30

32. General Hospital
Chicago, Illinois
Action:
Phlebotomy-­‐the
variable
standard
is
4.78
productive
hours
and
$90
per
100
Weighted
Tests,
or
10,160
hours
per
year
(5
FTE),
whichever
is
greater.
Action:
Testing-­‐the
variable
standard
is
12.97
productive
hours
and
$386
per
100
Weighted
Tests,
or
4,160
hours
per
year
(2
FTE),
whichever
is
greater.
• Analysis:
standard
is
equal
to
2009
annualized.
2009 Labor Standards
31

33. General Hospital
Chicago, Illinois
Geneva 08-027-2324
This
draw
station
opened
in
mid-­‐2007.
Only
a
very
small
number
of
point
of
care
tests
are
done
at
Geneva.
Routine
specimens
are
routed
to
Airport
Way
regional
lab.
Stat
tests
are
routed
to
KSMC
laboratory.
Dividing
weighted
volume
by
unweighted
volumes
yields
an
average
weight
across
the
years
for
comparison.
The
average
weight
is
a
labor
intensity
score
that
reflects
changes
in
the
service
mix.
A
rise
in
the
score
means
that
the
testing
mix
has
changed
to
be
more
!"#$%&'&()*
time-­‐consuming
per
test;
a
decline
in
the
score
means
that
the
testing
2.40
mix
is
becoming
less
labor-­‐intensive
per
test.
2.30
Phlebotomy
intensities
have
declined
from
2007.
As
the
volume
has
2.20
picked
up
since
2007,
it’s
likely
that
the
mix
fluctuated
too.
2.10
As
a
startup
period,
hours
per
unit
for
2007
are
not
comparable
to
2.00 2008-­‐09.
The
Phlebotomy
standard
was
derived
from
2009
hours
per
Avg Weight
1.90 unit,
the
most
efficient
year.
4 Year Avg
1.80
2007 2008 2009A
Action:
Phlebotomy-­‐the
variable
standard
is
4.70
productive
hours
and
$89
per
100
Weighted
Tests,
or
2,080
hours
per
year
(1
FTE),
whichever
is
greater.
• Analysis:
standard
is
equal
to
current
2009
performance.
2009 Labor Standards
32