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September 2009 Dashboard

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  • 1. Clinical Pathology Quality Dashboard September 2009
  • 2. Clinical Pathology Quality Dashboard Inpatient Phlebotomy First AM Blood Draws University Hospital 0% 20% 40% 60% 80% 100% Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2008 2009 8am 9am 10am Drawn by Mott Hospital 0% 20% 40% 60% 80% 100% Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2008 2009 8am 9am 10am Drawn by
  • 3. Clinical Pathology Quality Dashboard Inpatient Phlebotomy First AM Blood Test Results: PT/PTT, CBCP, and Comprehensive Panel University Hospital 0% 20% 40% 60% 80% 100% Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2008 2009 0 100 200 300 400 AvgDailyVolume 8am 9am 10am Results by Mott Hospital 0% 20% 40% 60% 80% 100% Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2008 2009 0 2 4 6 8 10 12 AvgDailyVolume 8am 9am 10am Results by
  • 4. Inpatient Phlebotomy Draws Clinical Pathology Quality Dashboard 19,773 26,062 19,759 20,459 19,598 19,795 21,992 21,714 20,986 21,651 22,073 22,675 0 5,000 10,000 15,000 20,000 25,000 30,000 Sep Oct Nov Dec Jan Feb Mar Apr May June July Aug 2008 2009
  • 5. Clinical Pathology Quality Dashboard Turnaround Times CSF Gram Stain Volume and Turnaround Time 0 20 40 60 80 100 120 140 160 Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2008 2009 MonthlyVolume > 1 hour 30 min-1 hour <30 minutes TAT Emergency Department Cardiac Marker Volume and Turnaround Time 0 200 400 600 800 1000 1200 1400 Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2008 2009 MonthlyVolume > 2 hours 1-2 hours <1 hour TAT Point of Care service began
  • 6. Clinical Pathology Quality Dashboard Specimen Processing Turnaround Time Average Daily Turnaround Time + 1 standard deviation for Inpatient Specimens going to Chemistry September 2006 - July 2007 0:00 0:14 0:28 0:43 0:57 1:12 Sep-06 Oct-06 Nov-06 Dec-06 Jan-07 Feb-07 Mar-07 Apr-07 May-07 Jun-07 TurnaroundTimeinMinutes October 2008 - August 2009 0:00 0:14 0:28 0:43 0:57 1:12 Oct-08 Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 TurnaroundTimeinMinutes
  • 7. Clinical Pathology Quality Dashboard Molecular Diagnostics Laboratory Specimens Received and Turnaround Time January 2002 - August 2009 0 200 400 600 800 1000 1200 1400 January 2002 July 2002 January 2003 July 2003 January 2004 July 2004 January 2005 July 2005 January 2006 July 2006 January 2007 July 2007 January 2008 July 2008 January 2009 July 2009 Month/Year SpecimensReceivedperMonth 0 1 2 3 4 5 6 7 8 9 10 TAT(days) # Specimens TAT Linear (# Specimens) Linear (TAT)
  • 8. Clinical Pathology Quality Dashboard Chemistry In-Lab Turnaround Times Sample Turn-Around Time 0 5 10 15 20 25 30 35 Aug O ct Dec Feb Apr Jun Aug O ct Dec Feb Apr Jun Aug Aug 07 - Aug 09 Percentage Routine >60 min >45 Inpt STAT >45 Outpt STAT
  • 9. UMHS Blood Product Utilization Clinical Pathology Quality Dashboard Crossmatch/Transfusion Ratio 1.3 1.4 1.5 1.6 1.7 1.8 1.9 Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 20 0 8 2 0 0 9 Threshold Wasted RBC 0.0% 0.5% 1.0% 1.5% 2.0% 2.5% 3.0% Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2 0 0 8 2 0 0 9 Threshold Wasted Platelets 0% 1% 2% 3% 4% 5% Sep Oc t Nov Dec Jan Feb Mar Apr May Jun Jul Aug 20 08 200 9 Threshold Wasted Plasma 0% 1% 2% 3% 4% 5% 6% Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 20 08 20 0 9 Threshold Wasted Cryoprecipitate 0% 5% 10% 15% 20% 25% 30% Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2 00 8 20 09 Threshold Blood Product Utilization 0 1000 2000 3000 4000 5000 6000 7000 8000 Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2008 2009 0 1000 2000 3000 4000 5000 6000 7000 8000 PatientPopulation Random Platelets Allo RBC Units Plasma Units Cryo Units Partial Units SD Platelets Adjusted DischargesUnits Used
  • 10. Clinical Pathology Quality Dashboard CAP Proficiency Testing 4th Quarter FY 2009 Clinical Pathology 91 = Number of Challenges 92% = Satisfactory Results Anatomic Pathology 0 = Number of Challenges N/A = Satisfactory Results Department Total 91 = Number of Challenges 92% = Satisfactory Results Clinical Pathology Scores 92 1009999.5 97 100 9998 0 100 200 300 400 500 600 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr NumberofChallenges 50 60 70 80 90 100 PercentSatisfactory FY2008 FY2009
  • 11. Clinical Pathology Quality Dashboard CP Financial Measures Monthly Amount Paid to Southeastern Michigan American Red Cross 1,000,000 1,050,000 1,100,000 1,150,000 1,200,000 1,250,000 1,300,000 Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 2008 2009 Dollars Clinical Path Expense per Test* $4 $5 $6 $7 $8 $9 $10 Jul-05 O ct-05 Jan-06 A pr-06 Jul-06 O ct-06 Jan-07 A pr-07 Jul-07 O ct-07 Jan-08 A pr-08 Jul-08 O ct-08 Jan-09 A pr-09 Jul-09 * excludes Blood Bank and Phlebotomy Clinical Path Tests per FTE and Total Tests By Month 1,000 1,200 1,400 1,600 1,800 2,000 Jul-05 O ct-05 Jan-06 Apr-06 Jul-06 O ct-06 Jan-07 Apr-07 Jul-07 O ct-07 Jan-08 Apr-08 Jul-08 O ct-08 Jan-09 Apr-09 Jul-09 TestperFTE 275,000 300,000 325,000 350,000 375,000 400,000 425,000 TotalTests Tests per FTE Total Tests
  • 12. • Lean Process Improvements – Many! • Board access H1N1 influenza testing program Clinical Pathology Quality Dashboard Clinical Laboratory Operations Initiatives
  • 13. • Design and implementation of new requisition for complex, multiple-site, multiple-times Interventional Radiology blood samples – by Chemistry • Outstanding improvements in ED turnaround times for troponins, CBCs, basic panels, and urine analysis - by Chemistry Clinical Pathology Quality Dashboard Clinical Laboratory Service Enhancements
  • 14. • Congratulations and Thank You to the entire Blood Bank/Transfusion Medicine group for a very successful rigorous FDA on-site inspection with “no observations”. • Kudos to the Microbiology Laboratory (especially Marc Deroo and Jeana Vandorp) for “above and beyond” support of Pediatrics Critical Care Medicine patient in early September. • Kudos to Duane Newton, Ph.D. (Director, Microbiology Laboratory) for his tireless and expert support of UMHS preparation for H1N1 influenza. • Kudos to Steven Mandell, M.D. for his leadership in helping to develop a “Better Specimen Box”. Dr. Mandell organized a team of 25 people – including nurses, managers, phlebotomists, pathologists, housekeepers, and others – to create what is now officially called a “unit- based specimen drop box”. Clinical Pathology Quality Dashboard Kudos

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