Case study: improving efficiency in a large hospital laboratory.

Abstract

Saint Francis Health System (SFHS) consists of three hospitals and one clinic: Saint Francis Hospital (SFH); Broken Arrow Medical Center; Laureate Psychiatric Hospital; and Warren Clinic. SFHS has 670 physicians on staff and serves medical (oncology, orthopedic, neurology, and renal), surgical, cardiac, women and infant, pediatric, transplant, and trauma patients in Tulsa County, Oklahoma, which has a population of 660,000. SFH incorporates 706 staffed beds, including 126 pediatric beds and 119 critical care beds. Each year, the health system averages 38,000 admissions, 70,000 emergency department visits, 25,000 surgeries, and 3,500 births. Saint Francis Laboratory is located within the main hospital facility (SFH) and functions as a core lab for the health system. The lab also coordinates lab services with Saint Francis Heart Hospital, a physician-system joint venture. The Optimal Equipment Configuration (OEC) Project was designed by the Clinical Laboratory Services division of Premier, a group purchasing organization, with the goal of determining whether laboratories could improve efficiency and decrease unit cost by using a single-source vendor. Participants included seven business partners (Abbott, Bayer, Beckman/Coulter, Dade/Behring, J&J/ Ortho, Olympus, and Roche) and 21 laboratory sites (a small, mid-sized, and large site for each vendor). SFH laboratory staff embraced Premier's concept and viewed the OEC project as an opportunity to "energize" laboratory operations. SFH partnered with Abbott, their primary equipment vendor, for the project. Using resources and tools made available through the project, the laboratory was re-engineered to simplify workflow, increase productivity, and decrease costs by adding automation and changing to centralized specimen processing. Abbott and SFH shared a common vision for the project and enhanced their partnership through increased communication and problem solving. Abbott's area representatives provided for third-party design expertise and quarterly metric reporting through Argent Consulting. Abbott incorporated lessons learned from the SFH OEC project with organizational changes to improve the way they work with customers. Following is a step-by-step description of the OEC project to allow others to benefit from the experience (Figure 1).