Improving Workflow With Water Spiders
Pathology gets lean
If you ask Steve Mandell, M.D., why Pathology invested time in a slate of lean projects for their Central Distribution area, he says simply, “We process more than 6 million tests a year.” Mandell is an assistant professor in the Department of Pathology, director of MLabs and Central Distribution, and the project champion of the Pathology lean team.
Lean project sponsor Jay L. Hess, M.D., Ph.D., Carl V. Weller Professor and chair of Pathology, sees that 6 million figure as the tip of the iceberg.
“The amount of testing we do is ever increasing. In addition, we’ll soon begin to design a new building to house our clinical laboratories,” Hess says. “It was essential for us to develop more awareness of lean processes and improve our workflow so that we don’t just design what we already have—only bigger.”
To make changes in the areas of phlebotomy (blood collection), the design of the laboratory and specimen analysis, the lean team applied several lean processes such as continuous improvement cycles, workflow analyses and “water spiders.”
Water spiders are not really insects. It is a lean term used for anyone who travels around a work environment, enabling workers and processes, usually by “carrying” materials quickly—but never disturbing the substance of the work performed.
“The idea of water spiders is so good I wish I’d thought of it myself,” says Cathy Howe, a phlebotomist in Pathology.
Howe is well acquainted with water spiders. In her world, water spiders are real-life human runners who take blood samples from 25 drop-off points in University Hospital directly to Pathology Central Distribution where they are delivered in 15-minute intervals around the clock.
“Any steps a phlebotomist can save during lab draws are helpful,” says Howe. “Now I don’t even have to leave the area. I can pick up requisitions, draw blood from patients and drop off samples at the handy drop-off points.”
It used to take around 32 minutes to cycle a blood specimen. Now it takes about nine minutes.
Previously, stat—or rush—requests were 40 percent of total blood draw requests. Now staff have faith in the system’s efficient turnaround, and the rate of stat requests is expected to drop to the single digits. The lean team also tackled standardized stocking of phlebotomy carts. “No matter which cart you take,” says Mandell, “you’ll have what you need, and you’ll know exactly where to find it.”
Thanks to lean design concepts, Pathology also redesigned three key parts of the core laboratory. In one instance, it took lab technicians 30 touch points—and 2,500 feet—to move a specimen from the patient to an analyzer. The new process, incorporating design changes to the lab and water spiders, improves turnaround times by 38 percent, reduces distance traveled by 33 percent and slashes waiting time by 78 percent. “In time, lean processes will be implemented throughout all our labs,” Mandell says. “This is just the beginning.”
To learn about other lean initiatives around the Health System, visit the Michigan Quality System Web site.