Supernova Award Category
The Problem
In “hybrid labs,” production line and/or staffing challenges impair the Lab’s ability to meet Turn Around Times (TATs) for multiple customers, but primarily for ambulatory orders. This frustrated providers, patients and lab co-workers, and needed to be addressed to accommodate growth particularly in Core Lab, where a majority of ambulatory orders were processed. In the absence of measurement tools, our labs struggled to understand what was expected of them from each customer segment and needed help to determine the best staffing/production approaches on all shifts to meet those expectations at the lowest cost possible. The commitment of Mercy Lab is to help each Mercy community achieve consistent TATs while also growing volume (or in some cases retaining volume).
The Solution
In May of 2015, Mercy began using industry-leading analytics utilizing a combination of data warehouse tables, ETL logic, Business Objects reporting universe, Epic’s EMR (Electronic Medical Record) reporting interface, SAP HANA, as well as a strong partnership with Mercy Labs. This led to a transformation of Lab workflow by utilizing the Lab Dashboard to identify and resolve workflow inefficiencies.
The results
Prior to the delivery of these analytic applications, Mercy was unable to zero in on the greatest areas of opportunity in their lab turnaround times – it was known that certain locations and certain labs had inefficiencies and opportunities for improvement, but it was not known where those opportunities existed. With our new solutions, lab leaders can now tell the turnaround time of their locations, of all labs processed in those locations and details about them such as who performed the lab, who ordered it, the time breakdown for each step and much more. Lab leaders can also find out on the same dashboard information from completely disparate systems all aggregated into one stop shop. They can find out HR information like the number of open positions, or how long it takes to fill a position or why coworkers leave. They can find out labor financial information associated with running lab departments. Additional information on the Lab Dashboard allows lab leaders to manage samples that are supposed to be in the lab but are not there for various reasons. And lastly, leaders can look at blood usage by physicians and offer suggestions for opportunity to improve practice to create a safer patient care environment.
Metrics
The Lab Dashboard has contributed to over a million dollars of savings, and we are still finding new insights. Contributing to this were savings in Point of Care testing and eliminated ordering for CK-MB tests. Additionally, it has contributed to microbiology consolidation savings as well as reducing equipment costs. The dashboard provides lab leaders the data to prove that turnaround time demands are met for skeptical customers. It provides HR measures, such as current open position, at a monthly rate instead of yearly and consolidated all of this information in one place, saving Lab leaders hundreds of hours. Due to the Lab Dashboard, the contract with external vendors will not be renewed and therefore saving Mercy thousands through that avenue as well. A significant benefit to the Lab Dashboard is the ease of use for Mercy lab leaders to obtain reports and information. What used to take hours, days, weeks to obtain through reporting, is now readily available on the Lab Dashboard in the Lab Information Space. This is a time saver and huge customer satisfaction improvement for our lab leaders. One of the biggest complaints with implementing Beaker, Epic’s Lab module, has been the difficulty in running reports and our solution has been able to provide lab leaders with the data needed to make decisions all in one place making the Lab dashboard not only one of the most used dashboard of all time but also contributing to over a million dollars in savings to Mercy so far.
The Technology
Mercy used a combination of data warehouse tables, ETL logic, Business Objects tools and Hana and Epic’s reporting interface to deliver the Lab Dashboard. Mercy used SAP BusinessObjects and added the use of SAP HANA for performance reasons. SAP HANA not only sped up the dashboards and datasets, but also delivered the solutions much faster since that performance enabled very rapid development. This toolset allows the daily refresh of data in the Lab dashboard.
Disruptive Factor
The game changing step in this project was taking an area with known opportunity and breaking it down to an actionable opportunity. Previous methods to gather this data took huge amounts of time to compile, and weeks to slice and dice, which prevented any follow up questions from reasonably being answered. Today, lab leaders can spot an anomaly in the data presented in a manner of seconds and quickly drill in to see what location or lab test stood out, and with just a few clicks after that they can see alternative options that are working in other circumstances. Surprisingly, the product was so valuable that physicians themselves now have access and utilize the Lab Dashboard to see that the turnaround times for the lab tests that they order are.
Shining Moment
The Lab Dashboard streamlined customer service. Reduced TAT by exposing time spent processing various customer segments e.g. Emergency Departments. Revealed HR metrics such as days to fill open positions by facility and turnover analysis, improving co-worker engagement, morale, and productivity. Improved patient safety by monitoring Blood Utilization by facility and ordering physician. Evaluated performance of variable salaries and rates to improve knowledge of labor costs with lab departments.