Making it LeanMaking it LeanShands AGH Core Lab Process Shands AGH Core Lab Process

Improvement and Layout RedesignImprovement and Layout Redesign

Mary Hageman and Lauren MilneShands HealthCare

OutlineOutline

• Introduction• Biographical Information• Problem Formulation• Objectives• Methodology• Recommendations• Financial Impact• Conclusion

Biographical InformationBiographical Information

Mary Hageman•University of Florida graduate•Magna Cum Laude in Dec 2005 with BS in Industrial and Systems Engineering•Starts as full-time engineer at MECS in February

Lauren Milne•University of Florida student•Industrial and Systems Engineering with minor in business•Plans to graduate May 2008•Intern at MECS since May 2005

IntroductionIntroductionWho Are We?Who Are We?

• Shands AGH• Ayers Medical Plaza• Rocky Point (located off-site)• Core Lab (located within Shands

AGH)• External Consulting Group

Benchmark

IntroductionIntroductionCurrent StateCurrent State

Hematology

Front Desk

Chemistry

Phlebotomy

Specimens arrive from patient rooms or the Emergency Room by

Phlebotomists

Specimens arrive from outpatient clinics

IntroductionIntroductionCurrent StateCurrent State

Hematology

Front Desk

Chemistry

Phlebotomy

Specimens accessioned and transported to appropriate testing

area

IntroductionIntroductionCurrent StateCurrent State

Hematology

Front Desk

Chemistry

Phlebotomy

Specimens advance through testingprocedures

IntroductionIntroductionCurrent StateCurrent State

Hematology

Chemistry

Problem FormulationProblem FormulationExternal Consulting Group

Implemented Staff Reductions

Need for Improvements Noted

Demand for Change in Staffing Levels and Increase Satisfaction

Project ObjectivesProject Objectives

• Identify process improvement opportunities to increase lab efficiency.

• Determine required staffing levels based on peak workload analysis.

• Design improved layout.• Quantify financial impact.

MethodologyMethodology

• SWOT Analysis• Lean Concepts• Systematic Layout Planning• Workload Analysis

MethodologyMethodologySWOT AnalysisSWOT Analysis

Top 5 Findings 1. Limited staff during busy times2. Split Chemistry and Hematology

departments3. Lack of effective communication4. Multiple processing areas5. Lack of cross-training

MethodologyMethodologyLean ConceptsLean Concepts

Transport

Overproducing

Waiting Over processing

Inventory

Motion

Defects orCorrection

SevenDeadly Wastes

MethodologyMethodologyLean ConceptsLean Concepts

The 7 Deadly Wastes Found and Eliminated

Short-Term•Inventory•Transport•Waiting•Motion

Long-Term•Over processing•Inventory•Transport•Waiting•Motion

Lean ConceptsLean ConceptsMotionMotion

103.42 Feet of Travel 85.44 Feet of Travel

Current Proposed

Total Savings: 17.98 Feet of Travel

MethodologyMethodologySystematic Layout PlanningSystematic Layout Planning

• Flowcharts– Front Desk– Hematology– Chemistry: Primary Tests– Chemistry: Other Tests

• Relationship Diagram • Proposed short-term and long-term

layouts

MethodologyMethodologySystematic Layout PlanningSystematic Layout Planning

• Relationship Diagram

MethodologyMethodologyWorkload AnalysisWorkload Analysis

Benchmark vs. Actual FTEs

0

5

10

15

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

Time of Day

FTEs

Actual FTEs Benchmark FTEs

• Add extra supply location for Test 7• Continue storing pre-made controls in

freezer• Relocate label printer• Move incubator to storage• Relocate heat block• Standardize receiving window layout• Purchase new head for cytospin

Recommendations Recommendations ShortShort--termterm

Move to a more central location

Recommendations Recommendations Relocate Heat BlockRelocate Heat Block

Recommendations Recommendations Receiving WindowReceiving Window

Interviewed Lab Technicians to see which equipment was used most often

Recommendations Recommendations Receiving WindowReceiving Window

Recommendations Recommendations Purchase New HeadPurchase New Head

Recommendation: Replace old cytospin

with new head for testing machine

Impact: Reduced walking time, maintenance costs and

space

ShortShort--term Impactterm Impact

• Examples of lean waste reduction:– Transport– Motion– Waiting– Inventory

• Maintenance cost savings• Better space allocation• Reduction of travel time by 62 hours

annually

RecommendationsRecommendationsLongLong--termterm

• Layout redesign• Purchase stacked printer stands• Relocate triage meter• Fill vacant position with swing shift

11 am to 7:30 pm• Spread out phlebotomy draws

between 1 am and 5 am to even workload

• Combine Chemistry and Hematology departments

• Relocate Phlebotomy behind front desk• Create break room • Create office for Assistant Lab

Supervisor• Provide centralized storage• Keep Hematology close to Blood Bank

RecommendationsRecommendationsLayout RedesignLayout Redesign

LongLong--term Impactterm Impact• Example of lean waste reduction:

– Transport– Motion– Waiting– Over processing– Inventory

• Improve lab and front desk coverage• Improve space allocation• Improve communication• Reduction of travel time by 478 hours annually

Financial ImpactFinancial ImpactShortShort--termterm

Financial ImpactFinancial ImpactLongLong--termterm

Financial ImpactFinancial ImpactLongLong--termterm

Financial ImpactFinancial ImpactOverallOverall

ConclusionConclusion

• All short-term recommendations have been implemented.

• Communication within the Core Lab has increased.

• Implementation of long-term layout changes will continue after executive approval.