Nation’s largest gathering of clinical laboratory Lean, Six Sigma, and process improvement practitioners took place in New Orleans this week
DATELINE: NEW ORLEANS, LOUISIANA—More than 300 of the nation’s leading quality improvement practitioners in clinical laboratory operations came together this week to share, learn, and master the best approaches to improving the quality of medical laboratory operations in ways that improve performance and productivity even while delivering substantial reductions in cost.
The opening session of the Ninth Annual Laboratory Quality Confab featured three clinical laboratories that have aggressively used quality management methods, including Lean and Six Sigma. These are labs that are strategically committed to creating and sustaining a culture of quality and continuous process improvement.
Eighteen-year Quality Journey at Sonora Quest Laboratories
The first speaker to address this topic was Jean Hammelev, Vice President, Quality & PMO at Sonora Quest Laboratories (SQL) and Laboratory Sciences of Arizona (LSA). Sonora Quest is a joint venture outreach lab company owned by Quest Diagnostics Incorporated (NYSE:DGX) and Banner Health. LSA is the operational business unit that manages the 13 hospital laboratories that support the 15 hospitals of Banner Health.
Hammelev described the lab’s quality journey, which began in the late 1990s: “In the early years, we implemented Six Sigma training throughout the company,” she stated. “Every team member was trained in the basics of these quality management tools.
“Building upon this foundation of education, we began to engage master black belts and develop a more systemic approach to quality,” continued Hammelev. “Quality improvement became infused in our strategy and our culture. During this time, we used Baldrige Quality Award parameters to develop leaders and to improve our ability to measure and analyze. Outside recognition of this effort came when SQL won the Arizona Governor’s Award for Quality.”
SQL has steadily increased the number of team members with advanced training in quality management. Currently it has two master black belts, three black belts, and more than 70 green belts available to support process improvement projects.
Laboratory at Henry Ford Health Operates All Labs to ISO 15189 Standards
The next speaker was John Waugh, System Vice President, Pathology and Laboratory Medicine at Henry Ford Health System in Detroit. His laboratory is unique in the United States. It has accredited eight hospital labs to the standards of CAP ISO 15189. It also runs 24 other lab sites—some in hospitals—using the same ISO 15189 standards.
“Our strategy was to create and sustain a culture of quality management and Lean across all our laboratory sites,” observed Waugh. “By achieving this, we created a common culture of continuous improvement in our labs. One major benefit from this effort was that the people closest to the work understood how to identify sources of waste and systemic errors and they have the tools to improve those situations.
The Henry Ford Health Laboratory first began working with Lean methods in 2004 and had a Lean specialist in place by 2005. “Each employee in our lab was required to complete 10 hours of Lean education,” stated Waugh. “We saw implementation of ISO 15189 as a platform to shorten the time required to implement Lean projects while boosting the impact of the improvements implemented from individual quality projects.”
The lab team at Henry Ford uses accurate metrics to track progress. For example, since 2008, projects to improve lab test turnaround times have generated the following improvements:
• 90% of ED Stats from 60 min => 30-35 min
• 95% of Troponin from 70 min => 35 min
• 90% of Inpatient STATS 90 min => 45 min
ISO 15189 at Biomedical Caledonia Medical Laboratory in Kingston, Jamaica
The Lab Quality Confab audience then heard about an international lab case study involving ISO 15189. At Biomedical Caledonia Medical Laboratory (BCML) in Kingston, Jamaica, Barbara Eugennie Hendriks, MT, AMT is the Managing Director.
The experience of BCML offered insights about two quality trends:
• First is the use of ISO 15189 to further the global standardization of medical laboratories; and,
• Second is how lab accreditation by a third party becomes a hallmark of quality for patients, physicians, and payers.
“Jamaica is an island nation of 2.8 million people,” stated Hendriks. “Currently, there are approximately 75 public and private laboratories serving this population. Biomedical Caledonia operates seven labs, including our central lab facility in Kingston. We also have 45 collection centers across the island.”
BCML’s quality journey actually started in the 1990s. “At that time, we wanted our quality to be validated by a third party,” explained Hendriks. “We initiated proficiency testing through MLE and explored certification to ISO 9001. Next, we began to have customers ask about the accreditation of our laboratory.
“Our opportunity came when the National Quality Infrastructure (NQI) project was implemented by the Government of Jamaica and the Swedish Board of Accreditation and Conformity Assessment (SWEDAC),” she continued. “The specific purpose of the NQI Project was to assist Jamaica to upgrade its NQI and bring it in line with requirements of the World Trade Organization.
“Biomedical Caledonia Medical was part of this pilot project and participated in training workshops,” noted Hendriks. “Our lab earned accreditation to the ISO 15189 standard on May 28, 2013. Because of this accreditation, our lab has better positioned itself to handle medical outsourcing and medical tourism, which is a significant opportunity in Jamaica.”
Hendriks identified these benefits from her lab’s accreditation to ISO 15189:
- Standardization of processes;
- Decreased operating costs with increased efficiency;
- An international reputable image for quality assurance and management, differentiating our lab at a high level for global competitiveness;
- Growth of customer satisfaction with better service provided;
- Confidence in results; and,
- Better profit hence better compensation for staff.
Laboratories, Workshops, and Certification Classes
This year’s Lab Quality Confab included management master classes where experts and consultants in different aspects of applying Lean and Six Sigma taught effective ways to improve:
- lab automation;
- lab informatics;
- Phlebotomy; and,
- analytical processes.
General sessions featured strategic insights and recommendations from respected lab leaders about how to understand healthcare’s transformation and match the changing needs of hospitals and physicians with the proven approaches for labs to utilize Lean and process improvement methods to deliver more value.
Management case studies, hands-on workshops and certification classes in the different tools, methods, and approaches of Lean, Six Sigma, process improvement, and ISO 15189 gave attendees another rich source of practical learning and information that they can take home and use in their own clinical laboratories and anatomic pathology groups.
Next year’s Lab Quality Confab is scheduled for October 18-17, 2016, in New Orleans at the Sheraton Hotel. Visit www.labqualityconfab.com for updates and more information.