A sold-out audience gathered at the seventh annual Lab Quality Confab and heard speakers from the nation’s most innovative medical laboratories share case studies about success in cutting lab expenses and improving quality
DATELINE: NEW ORLEANS, LOUISIANA—At a time when medical laboratories in the United States are experiencing significant financial challenges, there was plenty of guarded optimism among the clinical laboratory managers and pathologists who gathered in this famous city last week for the seventh annual Lab Quality Confab.
One reason for this optimism is that speakers and attendees at this sold-out meeting are the nation’s leading experts in the use of Lean, Six Sigma, and process improvement methods in medical laboratories and pathology groups. They know how to cut lab costs while maintaining quality and boosting the productivity of the lab’s staff and automated systems.
Cutting Costs in the Clinical Laboratory Even as Quality Increases
One great example is the laboratory division of the five-hospital Broward Health System in Ft. Lauderdale, Florida. In the 12-month period ending in July 2013, this laboratory had cut costs by $871,000. In his case study presentation, Leo Serrano, Corporate Director of Laboratory Services at Broward Health, explained how his lab team used quality management methods to reduce lab test spending through five separate programs:
- Esoteric test approval procedures were implemented for assays that cost more than $1,000. The result was savings of $220,000, plus outpatient revenue enhancement of $68,000.
- Reduced volume of send-out tests saved $74,000, based on use of formularies and ordering algorithms developed in tandem by the lab and the hospital’s physicians.
- The same formularies and ordering algorithms contributed to a reduction of in-house lab test utilization and produced savings of $97,000.
- Platelet waste reduction efforts generated cost savings of $200,000, as a result of greater adherence to utilization criteria, supported by computerized physician order entry (CPOE).
- Another big win for the lab’s cost-saving efforts was a reduction in red blood cell utilization of $ 212,000, due to better education on “best practices” that led to reduced utilization of these blood products.
Serrano’s presentation was one of 40 important sessions at Lab Quality Confab. The speakers all had inspiring success stories of achieving substantial cost savings in their medical laboratory organizations and pathology groups, without compromising quality or patient safety. Case studies about innovation are one noteworthy attribute of Lab Quality Confab that sets it apart from other meetings in the lab testing industry.
Clinical Laboratory at Mather Hospital Helps Reduce HAIs
Another clinical laboratory success story that caught the full attention of attendees at Lab Quality Confab was the $3 million in savings and substantial reduction in the number of hospital-acquired infections (HAIs) that was produced at the 248-bed John T. Mather Memorial Hospital in Port Jefferson, New York. This case study was presented by Denise Uettwiller-Geiger, Ph.D., DLM (ASCP), Director of Laboratory and Clinical Trials.
This is a story that combines new rapid diagnostic testing technologies for infectious disease with active collaboration between the lab team and hospital physicians. The goal was to develop new diagnostic and treatment protocols specifically designed to take advantage of rapid molecular testing in support of testing for MRSA and Clostridium difficile.
Uettwiller-Geiger provided impressive outcomes that powerfully demonstrated how, when physicians leverage the value of clinical laboratory testing, huge improvements in patient outcomes result, accompanied by multi-million-dollar savings in care associated with hospital-acquired infections.
63% Drop in Cases of Clostridium Difficile
To reduce the number of cases involving Clostridium difficile, Uettwiller-Geiger explained how, between the base year of 2009 and 2012, the combination of a new rapid lab assay and new care protocols contributed to a 63% drop in the annual number of C. diff cases, from 70 in 2009 to just 26 in 2012. During this same time period, the net savings from the reduction in C. diff cases to Mather Memorial Hospital was $1.5 million, despite increased spending of $86,000 in the lab for the rapid molecular testing!
Another source of HAIs is Methicillin-resistant Staphylococcus aureus (MRSA). The lab team at Mather Memorial Hospital introduced a rapid molecular assay—the Cepheid GeneXpert—that allowed it to do both real time PCR and RT-PCR on a 24-7 basis. With new care protocols in place, the combination of the new test and new clinical protocols produced a 76% reduction in cases, from 74 in the baseline year of 2008 to just 18 MRSA cases in 2012.
Use of the new molecular assay raised lab costs associated with MRSA testing to $440,000 between 2008 and 2012. But the increase in costs produced savings to the hospital of $2 million due to the reduction in MRSA infections. That, in turn, produced net savings from cost avoidance of $1.5 million.
Hospital Laboratory Contributed to $3 Million in Cost Avoidance Savings
The audience at Lab Quality Confab was both impressed and inspired by this example. Uettwiller-Geiger and her lab team produced net savings of $3 million to the John T. Mather Memorial Hospital during that five-year period, while boosting patient safety and improving patient outcomes. Moreover, the Mather lab’s case study provides a road map that every hospital laboratory can use to achieve similar results for their own parent organizations.
This year’s Lab Quality Confab was sold out and a record crowd was in attendance. Such a large number of attendees is evidence that progressive clinical laboratories and pathology groups are actively using Lean, Six Sigma, and process improvement methods to boost the quality of their lab testing services in a financially sustainable manner.
Clinical Laboratory Managers Can Learn More about Lab Quality Confab
Future DarkDaily.com e-briefings will address other presentations and developments that occurred during the seventh annual Lab Quality Confab last week. Clinical laboratory managers and pathologists interested in acquiring audio recordings and slides from the presentations delivered last week can visit www.labqualityconfab.com for details on how to order.