SkyRidge Medical Center Transition Presentation


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This power point was presented to administration as part of the transition to the new surgical tower and emergency center.

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SkyRidge Medical Center Transition Presentation

  1. 1. <ul><li>Emergency Center </li></ul><ul><li>Surgical Services </li></ul><ul><li>ICU / Surgical Suites </li></ul>Laboratory Transition Team
  2. 2. <ul><li>Emergency Center </li></ul><ul><li>Specimen Quality </li></ul><ul><li>Extended TAT </li></ul>Laboratory Transition Team
  3. 3. <ul><li>Mislabeled Specimens </li></ul><ul><ul><li>≥ 1 / month </li></ul></ul><ul><li>Contaminated Blood Cultures </li></ul><ul><ul><li>Improper collection technique </li></ul></ul><ul><li>Delayed specimen transportation </li></ul>Specimen Quality: Issues
  4. 4. <ul><li>Sample-related specimen rejection </li></ul><ul><ul><li>Accounts for 46% of specimen rejections </li></ul></ul><ul><li>Improper specimen labeling </li></ul><ul><ul><li>Not labeled at the time of collection in the presence of the patient </li></ul></ul>Specimen Quality: Issues
  5. 5. <ul><li>Advanced PCT Training </li></ul><ul><ul><li>Provided by Laboratory </li></ul></ul><ul><ul><li>Initial Training: </li></ul></ul><ul><ul><ul><li>8 hours for PCT </li></ul></ul></ul><ul><ul><ul><li>4 hours for Nurse </li></ul></ul></ul><ul><ul><ul><li>< 80 hours over 2-3 pay periods </li></ul></ul></ul><ul><ul><li>Continuous Reinforcement </li></ul></ul><ul><ul><ul><li>Periodic education at staff meetings as needed </li></ul></ul></ul>Specimen Quality: Suggested Solution
  6. 6. <ul><li>Improved Labeling </li></ul><ul><ul><li>Lab collection labels </li></ul></ul><ul><ul><li>Admission labels </li></ul></ul><ul><ul><ul><li>Print two sheets automatically when registered </li></ul></ul></ul><ul><ul><ul><li>Print manually </li></ul></ul></ul><ul><ul><li>Handwritten </li></ul></ul><ul><ul><ul><li>Blank labels / Sharpie </li></ul></ul></ul>Specimen Quality: Suggested Solution
  7. 7. <ul><li>Tube System </li></ul><ul><ul><li>Transportation of specimens as collected rather than in batches </li></ul></ul><ul><ul><li>Transportation of “add-on” lab requisitions </li></ul></ul>Specimen Quality: Suggested Solution
  8. 8. <ul><li>Improved specimen quality </li></ul><ul><li>Improved specimen rejection rates </li></ul><ul><li>Decreased contamination rates </li></ul><ul><li>Improved interdepartmental teamwork </li></ul>Specimen Quality: Expected Outcome
  9. 9. <ul><li>Time from order to receipt </li></ul><ul><li>Time from collection to receipt </li></ul><ul><li>Response time for laboratory collections </li></ul><ul><ul><li>Blood Cultures </li></ul></ul><ul><ul><li>Blood Bank </li></ul></ul>Issues Extended TAT:
  10. 10. <ul><li>Centralized slot board </li></ul><ul><ul><li>Organization of collection labels </li></ul></ul><ul><ul><li>Organization of reports </li></ul></ul><ul><ul><li>Visual organization of workflow </li></ul></ul>Suggested Solution Extended TAT:
  11. 11. <ul><li>Laboratory Assistance </li></ul><ul><ul><li>Phlebotomy area in third Triage </li></ul></ul><ul><ul><ul><li>Staffed from 1pm – 9pm Monday thru Friday </li></ul></ul></ul><ul><ul><ul><li>Assistance with Blood Bank and Blood Cultures </li></ul></ul></ul><ul><ul><ul><li>Assistance with EKG’s </li></ul></ul></ul><ul><li>Note: Promed “blue screen” required for Triage order entry </li></ul>Suggested Solution Extended TAT:
  12. 12. <ul><li>Blood Culture Teamwork </li></ul><ul><ul><li>EC staff draws 1 st set with initial blood work </li></ul></ul><ul><ul><ul><li>No line/I.V. draws (unless specified by physician) </li></ul></ul></ul><ul><ul><ul><li>Training provided by lab </li></ul></ul></ul><ul><ul><li>Laboratory draws 2 nd set </li></ul></ul>Suggested Solution Extended TAT:
  13. 13. <ul><li>Improved TAT </li></ul><ul><ul><li>Specimen collection </li></ul></ul><ul><ul><li>Lab reports </li></ul></ul><ul><li>Improved Blood Culture process </li></ul><ul><ul><li>TAT for 1 st set </li></ul></ul><ul><ul><li>TAT for initial blood work </li></ul></ul><ul><ul><li>Core measures </li></ul></ul><ul><ul><ul><li>Less delay in starting antibiotics </li></ul></ul></ul>Expected Outcome Extended TAT:
  14. 14. <ul><li>Surgical Services </li></ul><ul><li>Pre-operative process </li></ul><ul><ul><li>Blood Bank armbands </li></ul></ul>Laboratory Transition Team
  15. 15. <ul><li>Blood Bank armband (from pre-admission testing) required </li></ul><ul><ul><li>Delay in Blood Bank response time </li></ul></ul><ul><ul><ul><li>Distance (increased) </li></ul></ul></ul><ul><ul><ul><li>Staff unavailable or involved in critical case </li></ul></ul></ul><ul><ul><li>Delay in surgery schedule </li></ul></ul>Pre-operative Process: Issues
  16. 16. <ul><li>Transportation of Blood Bank armband thru tube system </li></ul><ul><li>Patient armband applied by outpatient lab personnel </li></ul><ul><ul><li>Patient identifiers cross-checked </li></ul></ul><ul><ul><ul><li>Includes Blood Bank ID card presented by patient </li></ul></ul></ul><ul><ul><li>Training provided by Blood Bank </li></ul></ul>Pre-operative Process: Suggested Solution
  17. 17. <ul><li>Less delays in pre-operative process </li></ul><ul><li>Improved time management for Blood Bank personnel </li></ul><ul><li>Improved interdepartmental teamwork </li></ul>Pre-operative Process: Expected Outcome
  18. 18. <ul><li>ICU / Surgical Suites </li></ul><ul><li>Nurse Collections (Line Draws) </li></ul>Laboratory Transition Team
  19. 19. <ul><li>Poor staff utilization </li></ul><ul><ul><li>Requirement for lab personnel to be present </li></ul></ul><ul><ul><ul><li>Generally unnecessary </li></ul></ul></ul><ul><ul><ul><li>Slower laboratory critical response time </li></ul></ul></ul><ul><li>Requires increased laboratory staffing </li></ul>Nurse Collections (Line Draws): Issues
  20. 20. <ul><li>Independent Nurse Collections </li></ul><ul><ul><li>Admission labels or lab labels for specimens </li></ul></ul><ul><ul><li>No line draws on blood cultures without physician order </li></ul></ul><ul><ul><li>Reference material provided for appropriate sample type, volume, etc. </li></ul></ul><ul><ul><li>Samples transported to lab thru the tube system </li></ul></ul>Nurse Collections (Line Draws): Suggested Solution
  21. 21. <ul><li>Improved TAT for ICU reports </li></ul><ul><li>Improved medical staff satisfaction </li></ul><ul><li>Improved time management for laboratory personnel </li></ul><ul><li>Improved interdepartmental teamwork </li></ul>Nurse Collections (Line Draws): Expected Outcome
  22. 22. <ul><li>Misty Prock, M.T. (ASCP) - Presenter </li></ul><ul><li>Amy Pickelsimer, M.T. (AMT) </li></ul><ul><li>Jerry Falls, M.T. (ASCP) </li></ul><ul><li>Sandi Butcher, M.T. (ASCP) </li></ul><ul><li>Betty Hudson, M.T. (ASCP) </li></ul><ul><li>Penni Miller, M.T. (ASCP) </li></ul><ul><li>Pam Barber, ASPT </li></ul>Laboratory Transition Team Thank You!