Find out how BJC HealthCare shortened turnaround time for lab results by 37%, reduced walking time, and managed staffing levels effectively. This helped them to immediately reduce operational costs. LeanHDX was the perfect tool to help BJC. Unique in its approach LeanHDX allowed BJC to consider the physical layout and the processes of the lab simultaneously.

1. Consolidating BJC’s
Diagnostic Labs
Eliminating Inefficiency
through Lean-Led Design

2. Today’s Speakers
Rodney Mullins
Performance
Improvement Manager
BJC Healthcare
Brittany Hagedorn
U.S. Healthcare Lead
SIMUL8
Special Thanks to Mike Lee for his help in making this project a success.

3. Agenda
1. The Problem with Labs
2. Layout Optimization
3. Operational Planning
4. Question and Answer

4. BJH Overview
• Academic hospital
• Campus includes BJH and SLCH
• Trauma Level 1 Emergency Room
• Staffed Inpatient Beds: 1,167
• Annual Admissions: 54,738

5. Labs:
Critical to Care
Diagnostic tests are used
in 70% of all medical
decision making.*
70%
*Forsman RW. Why is the laboratory an afterthought for managed
care organizations? Clin Chem. 1996;42:813–816.

6. Current State of BJH’s Labs
6+ separate labs, each with various
capabilities, scattered across the campus.
This resulted in inefficiencies and waste:
• Complicated logistics
• Delays in processing
• Excess staffing at slow periods during the day

7. Benefits of Consolidation
• Centralized receiving to simplify logistics
• Elimination of excess handling (if split
specimens between multiple lab locations)
• Reduce turnaround time for results
• Improve service to patients
• Increased capacity to support additional testing

8. Lean Design Approach
1. Value Stream Mapping (VSM) for
each existing lab to determine
workload and identify inefficiencies.
2. 5-day Rapid Improvement Event
(RIE) to develop an initial layout.
3. Simulation to estimate staffing.
4. Challenged to further reduce the
number of touches.
5. 2-day “mini” RIE to identify additional
improvements.
6. Simulation to compare both layouts
and anticipate impact.
Plan (Design
Requirements)
Design (Rapid
Improvement
Event)
Check
(Simulation)
Act
(Implement &
Review)

9. Design Questions
• What is the best layout for work stations?
• How will the new lab design handle the ebb and flow of
volumes over the course of the day?
• To what extent will staff roles and responsibilities in the
lab need to change?
• Will there be enough space for the full complement of
lab staff that will need to work there?
• How many staff will need to be on each shift throughout
the day?

10. Proposed Changes
• Consolidated work spaces and proximity to each
other in order to reduce the number of hand-offs and
the time spent walking between stations.
• Relocated the runner home base to provide better
visibility and reduce distance traveled.
• Created multi-functional overflow work stations to
handle peak volumes.
• Created single-piece flow that is based on a pull
model, to guarantee a FIFO inventory system.

11. Potential
Layouts
1
2

12. A Superior Design
Queuing Time at Sort Queueing Time at Clerical Queueing Time at Manual
Minutes
Initial Layout Improved Layout
With an improved layout, the team was able to further reduce the amount of time
that samples would spend waiting in various steps of the process.

13. Staffing Plan
Next was to create a data-driven
estimate for how many staff will be
needed to launch on day 1.

14. Staffing Decisions
At each level of hourly demand (250 arrivals in the above), the simulation was used
to compare delays and overall lab performance for a range of staffing levels.
Sort Register
Minutes(AverageWaiting)
3 staff 4 staff 5 staff 6 staff 7 staff

15. Anticipated Lead Time
250 arrivals per hour 420 arrivals per hour 580 arrivals per hour
Minutes
Average Queuing Time
As a new facility opens, it is important to set expectations about what level of delay
is realistic to anticipate, varying throughout the day due to demand. The above
values are for the total lead time to automation, assuming 5 water-spiders.

16. LeanHDX Live

17. Benefits of Simulation
with LeanHDX
 Data-driven decision making.
 Quick to build and test scenarios.
 Highly visual for stakeholder
engagement.
 Complements existing Lean tools.

18. Questions?
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