Article Text
Abstract
In early 2013, several outpatients at Sitaram Bhartia Institute of Science and Research in New Delhi, India complained that their laboratory results were not ready at the promised time. We reviewed the data for 3 months and learnt that 16% of outpatient results were not ready when patients returned to receive them. We formed a multidisciplinary team to fix the problem. After conducting a time-and-motion study, process mapping and discussions the team identified two key problems: (1) the laboratory consultant did not have a set time to validate the results and (2) the reasons of delay in laboratory reports were not documented; this made it hard to identify and solve specific reasons. The team decided to set a fixed time for the consultant to verify results and to document reasons for delay in each case. The team used Plan-Do-Study-Act (PDSA) cycles to finalise the verification system and to set up the documentation system. Documentation led to the identification of new problems which were also solved using PDSA cycles. Delay in reports reduced significantly from 16% in March 2013 to less than 3% in a period of 4 months. We have sustained these gains for the past 5 years.
- healthcare quality improvement
- laboratory medicine
- quality improvement
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
Footnotes
Twitter @Saru4q
Contributors SB has written the main document except for the background of the manuscript. SB conceptualised the improvement project and provided leadership for applying the quality improvement methodology. SB also worked with RG for data analysis and interpretation. PW has written the background and annotated the outcome and process measure graphs. PW supported the QI process and co-ordinated meetings with all stakeholders. PW also collected data. RG provided leadership in engaging the laboratory staff and actively engaged in the brainstorming sessions for coming up with change ideas.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This project was deemed to be an improvement project and not a study on human subjects. Therefore, ethical improvement was not required.
Provenance and peer review Not commissioned; externally peer reviewed.