Assignment: Applying Methods of Process Improvement to Improve Productivity
Consider the following scenario:
Terry is a senior histology lab technician at a large urban hospital. He is responsible for overseeing a team of six junior technicians to process samples for testing. Recently, the hospital has introduced a new process whereby the senior histology lab technician must visually accept and approve the findings of the junior technicians in order for samples to be cleared and entered into the electronic health record for disease diagnosis. Terry has been able to meet this new need for the past few months. However, as more cases are entering the histology lab, cases have started to become backlogged. Additionally, the histology lab hours are restricted to business hours; this has severely impacted the processing of histology samples. Terry is worried that the approval process is not efficient and that perhaps a second senior histology lab technician should be hired to meet around-the-clock demand.
As a current or future health care administrator, how might you address the productivity lag in the histology lab in the scenario?
For this Assignment, review Case 2, “Noninvasive Cardiovascular Laboratory” in Chapter 8 of the text, Managing Health Services Organizations and Systems. Reflect on how you, as a current or future health care administrator, might be required to identify opportunities to improve productivity in an HSO. What types of information might you need to gather? How might you identify whether a process improvement opportunity exists? Then, review the Week 3 Case Questions document in this week’s Learning Resources to complete the Assignment.
The Assignment (3–5 pages):
• Complete the case questions presented.
• Create a fish bone diagram and a flow diagram that represent an analysis of the processes for improvement and implementation approaches to support your answers to the case questions.
• Be sure to support your answers with support from the literature.
Case Study 2 with questions on page 3
Noninvasive Cardiovascular Laboratory The assistant vice president for operations at Barbarossa Hospital has identified a problem concerning the noninvasive cardiovascular laboratory (NCVL). First, patients have complained to their physicians about long waits and interruptions during tests. Second, the number of tests ordered increased when more LIPs joined the professional staff organization early this year, and the only NCVL technician, Loren Findley, has told his supervisor that he is overworked. Findley has threatened to resign if he does not get a full-time assistant. The hospital has no other employees who can perform the tests. The tests are not difficult; Findley could train someone to perform them in about 2 months. Findley schedules all inpatient and outpatient tests ordered by house staff (residents) and attending physicians. Phone calls to schedule tests are received frequently during the day. On average, three of four of the tests Findley administers are interrupted by phone calls. It takes 10 minutes to return to the point in the test before the interruption (2 minutes talking on the phone and 8 minutes to restart the test). Observing the technician and talking with him and his supervisor provided the following information. The NCVL is located on the third floor of the hospital. It is adjacent to the stress test laboratory, which has twice the space of the noninvasive laboratory but uses only half of it. The stress test technician is productive only 60% of the time. Findley’s workspace is cramped and crowded with two patient beds, a very large desk, and supplies in boxes that are stacked floor to ceiling along two walls. The room’s configuration does not permit easy movement, and some equipment must be placed in the hall. Consequently, Findley spends an average of 10 minutes moving equipment into or out of the room when setting up for a test that is different from the preceding one. Findley is qualified to administer three tests:
1.Echocardiography (ECHO): A graphic recording generated by ultrasound that is used to study the structures and motions of the heart
2.Ocular plethysmography (OPG): A test to measure changes in size and volume of the eye
3.Pulse volume recording (PVR) plethysmography: A test to measure changes in volume of a cross-section of a blood vessel over several heartbeats Extensive observation showed the following standard times for each test (assume there is no difference for inpatients and outpatients): Hospital records were used to compare the number of tests performed last year with the number performed in the first 3 months of the year: The typical pattern for scheduled tests on any given day is ECHO, ECHO, OPG, ECHO, ECHO, PVR, ECHO, ECHO, OPG, and so forth.
Questions
1.Is Findley overworked? Why or why not? Should another technician be hired?
2.Assume that there is no budget to add a new technician. How should the current NCVL process be changed to improve quality and productivity?
3.Draw a cause-and-effect (fishbone) diagram of the reasons Findley’s work is inefficient.
4.Draw a flow diagram showing the steps in the process(es) for Findley’s work.
