Anatomic Pathology and Quality Process Improvement 17 December 2013 - - PowerPoint PPT Presentation

Anatomic Pathology and Quality Process Improvement

17 December 2013

CLINICAL LAB PRODUCTS

Webcast

Steve Halasey Chief Editor Clinical Lab Products

SPONSORS

Quality Process Improvement

In ¡a ¡clinical ¡histology ¡laboratory, ¡the ¡goal ¡of ¡quality ¡process ¡ improvement ¡is ¡to ¡improve ¡and ¡ensure ¡the ¡safety, ¡quality, ¡and ¡ cost-­‑efficiency ¡of ¡the ¡lab. ¡

TODAY’S WEBCAST

TODAY’S WEBCAST Topics for Today’s Webcast

• The ¡principles ¡of ¡quality ¡process ¡improvement ¡
• The ¡advantages ¡of ¡quality ¡process ¡improvement ¡in ¡the ¡histology ¡lab ¡
• The ¡value ¡of ¡incorpora=ng ¡LEAN ¡into ¡the ¡histology ¡process ¡

¡

PRESENTER

William DeSalvo, BS HTL(ASCP) Owner, Collaborative Advantage Consulting Chair, NSH Quality Management Committee Board Member, Digital Pathology Association

William DeSalvo, B.S. HTL (ASCP) William DeSalvo, B.S. HTL (ASCP)

System Production Manager in Anatomic Pathology Chairman, National Society for Histotechnology Quality Management Committee Board Member, Digital Pathology Association Owner/Consultant, Collaborative Advantage Consulting

Why Do We Need To Do This? Why Do We Need To Do This?

} Develop new TOOLS to Manage Quality } Develop New Workflows } Efficiently Manage Workload } Better Utilize Technical Staff } Prepare for Personalized Medicine } Meet the Demands of Our Patients } Create a Competitive Advantage for the YOUR Lab

How How Do We Do This? Do We Do This?

} Use Existing Methodology

• LEAN

LEAN

• Methodology used by manufacturing, most notably Toyota, that

focuses on: SPEED ( Removing Wasted Time)

• Si

Six Si Sigma gma

• Methodology used in many businesses, most notably Quest and

Motorola, that focuses on: QUALITY (Defect/Error Reduction) LEAN Six Sig LEAN Six Sigma ma Processes/Products with Better Quality Faster

How How Do We Do This? Do We Do This?

} Couple Methodolog

Couple Methodology w y with Technolog ith Technology y

• LEAN Production/Manufacturing
• Reduce Waste

Waste

• Improve flow
• Use a specific set of Tools

Tools

• Implement Smart Automation Instrumentation

Implement Smart Automation Instrumentation

• Sakura Xpress, Auto-TEC, Prisma, ??

CO-LOCATION

What is Process Improvement? What is Process Improvement?

} Strateg

Strategic Manag ic Management ement

• Identifying, Analyze and Improve the existing process

} Best Practice Benchmarking

Best Practice Benchmarking

• Comparing your process with a better process to improve

your process

• Remove Paradigm Blindness
• Improve effectiveness

What are the benefits? What are the benefits?

} Increased Consistency through Standardization } Improved Efficiency } Increased Productivity } Customer Satisfaction – Decreased TAT } Employee Satisfaction – Workload Leveling, Stress

Reduction

} Reduced Supply Costs } PATIENT SATISFACTION - DEMAND

PATIENT SATISFACTION - DEMAND

Understanding Understanding LEAN and Quality LEAN and Quality

} A way to understand VALUE

VALUE from the customer’s viewpoint (VOC VOC)

} Remove non-value added activities to ELIMINATE WAS

ELIMINATE WASTE TE

} Create VELOCITY

VELOCITY and CONTINUOUS CONTINUOUS FLOW FLOW in a process

} Develop a process that is PULLED

PULLED by the customer

} Create SUPERIOR

SUPERIOR and CONSISTENT CONSISTENT products

} Reduce COST

COST per test

} Provide tools for CONTINUOUS IMPROVEMENT

CONTINUOUS IMPROVEMENT

Understanding Understanding LEAN and Quality LEAN and Quality

} LEAN PHILOSOPHY

• Produce WH

WHAT is needed, WHEN WHEN it is needed - as specified by the CUSTOMER CUSTOMER – with the MINIMUM amount of materials, equipment, labor and space

• Provide an effective development, product and service

delivery SYSTEM SYSTEM that maximizes the ability of employees to add value

Understanding Understanding LEAN and Quality LEAN and Quality

} KEY LEAN PRINCIPLES

• Strive For Continuous One-Piece Flow (Hard to achieve)
• Place Linked, Value Added Processes Together

(Co-Location)

• Standardize Work
• Eliminate/Reduce Inventory
• Balanced Workloads
• Segregate Processes By Complexity
• Establish A Visual Workplace
• Eliminate Loop-Backs

Non-LEAN Histolog Non-LEAN Histology Lab y Lab

} Most Labs } Multiple bottlenecks in the work process } Long wait times from step to step due to batching } Staff scheduling not matched to

workload/ workflow

} Customer dissatisfaction –

Pathologist/ Clinician/Patient

} Inefficient/old equipment not designed for today’s

requirements

} PATIENTS WILL NOT STAND FOR THIS

PATIENTS WILL NOT STAND FOR THIS

LEAN Pressures on the Histolog LEAN Pressures on the Histology Lab y Lab

} The FUTURE IS NOW } Decrease TAT for tissue processing } Decrease TAT for all Staining – IHC/Molecular } Reduce rework to maintain and/or reduce cost } Improve Quality } Increased Productivity } Be the Benchmark Lab of Choice

Quality LEAN Histolog Quality LEAN Histology Lab y Lab

} Purchase instruments designed to work with

LEAN Process

} Standardize all or PART of the Process } Reduce the Bottlenecks } Eliminate Waste } Reduce Cost } Improve QUALITY } Improve Patient Satisfaction

Quality LEAN Histolog Quality LEAN Histology Lab y Lab

What are the Obstacles?

• Lack of Standards

Lack of Standards

• Individual standard operating procedures; Site QC/QA
• Lack of Documentation

Lack of Documentation

• Procedures/Policies; Training/Competency; Validation
• Subjective Quality

Subjective Quality

• Single point QC; End-Point QC

Quality LEAN Histolog Quality LEAN Histology Lab y Lab

What are the Obstacles?

• Misunderstanding

Misunderstanding of Process

• f Process
• Communication; Engagement
• Statistics

Statistics

• Data Collection; Data Crunching
• Everyone Must Participate

Everyone Must Participate

• Responsibility; Engagement; Continuous Improvement

Quality LEAN Histolog Quality LEAN Histology Lab y Lab

l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l CONSTANT BOTTLENECKS BATCH AND QUEUE PROCESSING

Processing Inspection FIRST IN => SOMETIME OUT DELAYED ACTION - SLOW FEEDBACK

l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l CONTINUAL FLOW / INSPECTION ONE PIECE/SMALL BATCH CONTINUOUS PROCESSING

FIRST IN => FIRST OUT IMMEDIATE ACTION - IMMEDIATE FEEDBACK Processing / Inspection

Quality LEAN Histolog Quality LEAN Histology Lab y Lab

Quality LEAN Histolog Quality LEAN Histology Lab y Lab

STAFF SCHEDULE FOR CONTINUOUS FLOW PROCESSING

ONE SHIFT - DAY

6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM HT1 HT2 HT3 HT4 HT5 HT6

STAGGER STAFF SCHEDULES TO MEET THE DELIVERY OF SPECIMENS END OF DAY - SUSPEND PROCESSING AND PICK-UP NEXT MORNING

Quality LEAN Histolog Quality LEAN Histology Lab y Lab

DELIVERY OF SLIDES TO PATHOLOGISTS - CONVENTIONAL PROCESSING

6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM CASES 35 30 25 20

160 TOTAL CASES DISTRIBUTED

15 10

DELIVERY OF SLIDES TO PATHOLOGISTS - CONTINUOUS FLOW PROCESSING

6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM CASES 35 30 25

195 TOTAL CASES DISTRIBUTED

20 20% PRODUCTIVITY INCREASE 15 10

WORKLOAD LEVELING & MULTI-TASKING ALL DAY BATCH WORKLOAD - LINEAR TASKING / NO LEVELING

Quality LEAN Histolog Quality LEAN Histology Lab y Lab

The QUALITY Model The QUALITY Model

• Increased Production Performance (Productivity)
• 20-

20-40% 40% increase in cases processed per hour per tech

• Reduced repeat work 40%
• Reduced reagent costs 50%
• Reduced TAT
• Employee satisfaction through Workload Leveling

Quality LEAN Histolog Quality LEAN Histology Lab y Lab


 The Cost of Quality The Cost of Quality

• Controllable – direct costs to ensure that only acceptable

products and services reach the customer

• Equipment - costs to invest in equipment to measure, accept,
• r control a product or service

COQ COQ Cost of Units Produced (C x #units) = COQ Cost of Units Produced (C x #units) = COQ COPQ COPQ

Cost of Unit (C x #units) + Cost of Rew Cost of Unit (C x #units) + Cost of Rework (Cx4-10 x #units) = COQ

• rk (Cx4-10 x #units) = COQ

Reduce Rew Reduce Rework and Reduce Cost

• rk and Reduce Cost

Quality Quality LEAN LEAN Histolog Histology Lab y Lab

Ø Smartest Automation Cannot Fix Lab Process

Problems

Ø Select Instrumentation that can be Flexible Ø Implement Instrumentation to Assist in

Change and Improve Quality

Ø Focus on Overall Process Improvement Ø Commit to Continuous Process Improvement Ø Be Patient Centric

Be Patient Centric

Q&A Audience Q&A

To ¡ask ¡a ¡ques=on, ¡navigate ¡to ¡the ¡Ques=ons ¡sec=on ¡of ¡the ¡ GoToMee=ng ¡control ¡panel. ¡ ¡ ¡

SPONSORS

www.milestonemedsrl.com/histopathology ¡ www.sakuraus.com ¡

CONTACTS

¡ William ¡DeSalvo ¡ ¡ wdesalvo.cac@outlook.com ¡ ¡ 602/685-­‑5000 ¡ ¡ ¡ ¡ ¡ Steve ¡Halasey ¡ ¡ shalasey@allied360.com ¡ 626/219-­‑0199 ¡ ¡ ¡

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