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Mayo’s Clinical Laboratory Science Program Uses Lean/Six Sigma to Speed Applicant Reviews and Rolling Admissions

Lean/Six Sigma project at Department of Laboratory Medicine and Pathology improves the admissions review and acceptance processes for new students

When it comes to the use of Lean/Six Sigma methods, Mayo Clinic’s  Department of Laboratory Medicine and Pathology (DLMP) has been at it for several years already. However, unlike most other clinical labs that focus Lean projects primarily to the flow of specimens through the laboratory, the Mayo Clinic DLMP has applied Lean to administrative work flow, with interesting results.

One such Lean project to improve office processes at DLMP was shown as a poster at the last Lab Quality Confab by Fazi Amirahmadi, Ph.D., who is the Systems Engineer Manager at Mayo Clinic’s DLMP. He presented the poster and explained how process-improvement protocols were applied to the Clinical Laboratory Science (CLS) admissions process. This poster earned a national award at Lab Quality Confab.

Clinical Laboratory Applies Lean Methods to Office Processes

It is unusual for any clinical laboratory organization to apply Lean and Six Sigma methods to office processes. But the gains are worth the effort. After Mayo Clinic’s Department of Laboratory Medicine and Pathology applied process-improvement protocols to the Clinical Laboratory Science (CLS) admissions process, it significantly shortened the time from when a student first applies to the program and when he or she is accepted.

“This improved turnaround time for the admissions process directly benefits both students and our academic program,” explained Amirahmadi. “First, students prefer a speedier acceptance decision because it reduces uncertainty in their planning. Second, faster acceptance decisions enable Mayo Clinic to compete more effectively for the top candidates for these positions.”

Mayo Clinic’s DLMP Is Among Nation’s Busiest Medical Labs

DLMP is one of the busiest clinical laboratories in the United States and one of the largest in the world. It has 160 physicians and scientists  and processes more than 20 million tests annually. Its total staff of about 3,200 work in more than 60 specialty medical laboratories.

“Usually labs apply Lean and Six Sigma methods to improve work processes that involve how specimens are handled and tested,” observed Amirahmadi. “Lean and Six Sigma techniques are not used much for work processes in the office or for graduate school admissions. But when we applied our Lean improvement methods to our rolling admissions process, the results were eye-opening for everyone. They found there is no limitation as to how and where we can use Lean and all of these process improvement tools.”

At Lab Quality Confab 2011, Fazi Amirahmadi, Ph.D., (at right), the Systems Engineer Manager at Mayo’s Department of Laboratory Medicine and Pathology, received a national award for his Lean Six Sigma poster presentation titled: “Applying Lean to Improve the Clinical Laboratory Science (CLS) Rolling Admissions Process.” Handing the award to Amirahmadi is Robert L. Michel, Founder and Producer of Lab Quality Confab.

At Lab Quality Confab 2011, Fazi Amirahmadi, Ph.D., (at right), the Systems Engineer Manager at Mayo’s Department of Laboratory Medicine and Pathology, received a national award for his Lean Six Sigma poster presentation titled: “Applying Lean to Improve the Clinical Laboratory Science (CLS) Rolling Admissions Process.” Handing the award to Amirahmadi is Robert L. Michel, Founder and Producer of Lab Quality Confab.

A certified ASQ-Six Sigma Black Belt, Amirahmadi has more than 20 years of industrial, teaching, and consulting experience. He earned his Ph.D. in Industrial and Management Systems Engineering from University of Nebraska-Lincoln.

“For more than three years, the CLS faculty and staff at the Mayo School of Health Sciences College of Medicine were under much stress to review applications from potential new students while also meeting their teaching responsibilities,” he explained. “Our program accepts 24 students each year.”

Recognizing that the existing workflow for reviewing applications needed improvement, Mayo Clinic’s CLS program director Sue Lehman asked the Systems Engineering team for assistance in streamlining the rolling admissions process. “We engaged the faculty with the shared goal of improving rolling admissions activities and increasing efficiency,” noted Amirahmadi.

“This Lean improvement project delivered significant benefits in short order,” he continued. “The overall measurement was the time between the date students applied and the date they received an admissions decision from the program.  After implementation this measure improved significantly. Wait times shrank from an existing state of 29-68 days, to a range of 22 to 43 days, a reduction of 22% to 36%, with a commensurate reduction in the range of variability for this process. . (Note, we do not have control over 15-35 days of the value stream, which is the time it takes for a candidate to make travel arrangements for the interview and accept an offer.)

“When we began this project in February 2010, the recruitment and admission processes were so slow and inefficient that the program had a high probability of losing competitive candidates to other teaching institutions,” observed Amirahmadi. “Our goal was to refine the admissions process to maximize recruitment and admission of outstanding students.

“This would enable the CLS program to compete more effectively with other institutions for excellent candidates and to boost the efficiency of their admissions process,” he added. “We also wanted to improve communication, collegiality, and teamwork among faculty members.

“A first step was to prepare a value-stream map of the recruitment and admission process,” noted Amirahmadi. “The value-stream map showed the time needed to complete the entire process, starting from the moment that a candidate applies online until the moment when that candidate is accepted into the program.

“The total wait time for candidates—from the time the online application is complete to the time it takes to receive an acceptance offer—averaged 28-67 days,” he said. “Notably, the time spent processing an application and evaluating a candidate was just 1-1.4 days. This meant that the majority of the total waiting time and processing time for applicants was 29-68 days, or from one to two months.

Value-Stream Mapping Identified Improvement Opportunities

“Using the value-stream map, we then analyzed each step in the process in order to eliminate waste and inefficiencies,” Amirahmadi explained. “During this analysis, team members identified improvement opportunities. These ranged from scheduling open houses for potential recruits to increasing communication with contacts and standardizing recruitment presentations.

“The team also identified improvement opportunities to implement once an application is received,” he recalled. “These suggestions included:

1)     blocking out time on faculty members’ calendars for interviews;

2)     creating a digital application review form; and,

3)     having faculty review electronic applications and communicate via email.

“Finally, the team developed parameters for the interview itself, including the processes around acceptance or rejection of an applicant,” Amirahmadi stated. “The team also developed a post-graduation survey of students and employers, and a dashboard for monitoring admissions.

“Based on our future state map, we determined that the ideal total wait time should be 23 to 44 days and the total processing time should be 6.23 hours—less than one day—for a total ideal time of 23.8 to 44.8 days,” he explained. “If we reach this goal, we would have an improvement of 18.5% to 34.5% in turnaround time (TAT).

“Other indicators that we used to measure the performance of our value stream were interview TAT (completed application to offering interview) and offering slot TAT (interview to offering slot to candidate). We had more control over wait times in these two TATs. After implementation, interview TAT of 3-12 days was reduced to 2 days (33%-83% reduction) and offering slot TAT of 2-6 days was reduced to 1 day (50%-83% reduction),” he stated.

“Having improved the process of identifying candidates, we are now seeking to improve how we match students to clinical laboratory openings after they graduate,” he said. “We are streamlining and improving that process just as we did with the CLS rolling admissions process improvement project. Our team members include Sue Lehman, Alisa Sokolik, Kelly Nelson, Lora Vrieze Spencer, Roeun Im, Melissa Gillis, and Ruth Baires Raihle. “They have demonstrated great teamwork in getting the results that we have achieved.” Amirahmadi said.

“Also, producing such dramatic results and winning the national award from Lab Quality Confab and The Dark Report has led other educational units in our department to ask us to consult with them about how to improve their processes,” he added. “That fact that other educational units have noticed our good work is very rewarding.”

At the upcoming Sixth Annual Lab Quality Confab, to be held November 6-7, 2012, in San Antonio, Texas, poster sessions will again take place. National awards and prizes totaling $3,000 will be awarded for the best Lean Six Sigma posters in the categories of clinical laboratory and anatomic pathology. To see topics, speakers, and all the events at Lab Quality Confab, visit http://www.labqualityconfab.com. To register for Lab Quality Confab, visit http://www.labqualityconfab.com/register.

—Joseph Burns

—Joseph Burns

Related Information:

Applying Lean to Improve the Clinical Laboratory Science Program Rolling Admissions Process

Continuous Process Improvement: Using Systems Engineering to Improve Laboratory Operations

5 Tips for Applying Six Sigma from Three Top Hospitals

Lean Six Sigma Forum at The Mayo Clinic in Rochester, MN

Use of lean and six sigma methodology to improve operating room efficiency in a high-volume tertiary-care academic medical center

Lab Quality Confab in San Antonio Nov 6-7

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