Barakauskas Vilte E, Bradshaw Tiffany A, Smith Lonnie D, Lehman Christopher M, Johnson-Davis Kamisha L
From the Department of Pathology and Laboratory Medicine, Children's and Women's Health Centre of British Columbia, Vancouver, Canada Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada.
ARUP Laboratories, Salt Lake City, UT.
Am J Clin Pathol. 2016 Aug;146(2):182-90. doi: 10.1093/ajcp/aqw087. Epub 2016 Jul 24.
Timely reporting of immunosuppressant (ISP) drug level results is needed for transplant patient management. This study characterized the local ISP testing process, identified bottlenecks and implemented process improvements to meet turnaround time requirements.
Laboratory information time stamps, direct observation and discussion with staff were used to construct a value stream map of the ISP testing process to identify process bottlenecks. Improvements were implemented to attain the required turnaround time.
Baseline performance of the existing ISP process (seven weeks, n = 272 samples) indicated that only 28% of samples were reported by 2:00 pm Major bottlenecks were identified to be the analytical run schedule, instrument delays, difficulty identifying ISP samples at intake, and difficulty collecting specimens. Process changes resulted in a median of 76% samples reported by 2:00 pm
: Adjusting ISP collection and analysis processes improved the laboratory's ability to meet physician requested result reporting time of 2:00 pm.
移植患者管理需要及时报告免疫抑制剂（ISP）药物水平结果。本研究对当地ISP检测流程进行了特征分析，识别了瓶颈问题，并实施了流程改进以满足周转时间要求。
利用实验室信息时间戳、直接观察以及与工作人员的讨论，构建ISP检测流程的价值流图，以识别流程瓶颈。实施改进措施以达到所需的周转时间。
现有ISP流程的基线表现（七周，n = 272个样本）表明，只有28%的样本在下午2:00前报告。主要瓶颈被确定为分析运行时间表、仪器延迟、在接收时难以识别ISP样本以及难以采集标本。流程变更后，中位数为76%的样本在下午2:00前报告。
调整ISP采集和分析流程提高了实验室在下午2:00前报告医生要求结果的能力。
