Chap 2: Optimizing Laboratory Workflow and Performance

Question 1

Components of workflow

Answer 1

• Pre-analytic
• Analytic
• Post-analytic

Question 2

Path of the workflow

Answer 2

1. The patient
2. Test selection
3. Sample collection
4. Sample transport
5. Report creation
6. Report transport

Question 3

What should be considered in the entire process?

Answer 3

• Beginning (sample collection)
• End (reporting and saving of results)
• All processes in between

Question 4

True or False: Laboratory testing process cannot vary from one facility to another

Answer 4

False

Question 5

Steps in Laboratory Testing process

Answer 5

• Testing phase
  - Pre-analysis
  - Analysis
  - Post-analysis
• Role
  - Physician
  - Laboratory
• Technology
  - Pre-analytic work cell
  - Analyzer
  - Analytic work cell

Question 6

A prerequisite to any performance optimization strategy

Answer 6

Understanding the workflow

Question 7

Issues to consider when auditing operations

Answer 7

• Test ordering – where are orders placed?
• Sample collection – who collects the samples?
• Transportation – how are samples delivered?
• Sample receipt – is there a central receiving area?
• Sample processing – are samples centrifuged centrally or in distributed locations?
• Testing – how many workstations are used?
• Reporting – how many results reported?

Question 8

Techniques to Collect Workflow Data

Answer 8

1. Sample and Test Mapping
2. Tube analysis
3. Workstation Analysis
4. Test ordering patterns / interviews
5. Task mapping

Question 9

It is a technique used to analyze the distribution of samples and tests overtime

Answer 9

Sample and Test Mapping

Question 10

Daily and hour tests

Answer 10

Day Interval

Question 11

batched tests

Answer 11

Week interval

Question 12

Goals of Sample and Test Mapping

Answer 12

• identify overall workload patterns to assess where resources are matched to the needs.
• performance indicators (TAT) can be improved

Question 13

Use to compare or check the past to present results

Answer 13

delta checks

Question 14

automations can reduce labor but redesigning workflow is cheaper and more efficient

Answer 14

Tube Labor

Question 15

Tube labor includes

Answer 15

1. sorting & centrifuging
2. Aliquoting
3. Racking
4. Unracking
5. Loading
6. Loading and Unloading of samples of analyzers
7. Retrieving tubes for add-on tests
8. Performing manual dilutions/reruns
9. Storing tubes

Question 16

Tube analysis

Answer 16

• # of containers other than tubes

- # of reruns needed as the results of instrument flags/laboratory policies

Question 17

True or False: Redesigning the workflow is less expensive and more efficient

Answer 17

True

Question 18

Goals of Workstation analysis

Answer 18

1. Instrument audit (LIS)
2. Test Menu
3. Processing mode & Load Balancing
4. Interviews
5. Task Mapping

Question 19

It is a test-based system used to perform specific % of test per hour and they are irrespective of how many tests are ordered.

Answer 19

Chemistry analyzers

Question 20

True or False: Test menu is used if a test is performed only once or twice a week.

Answer 20

True

Question 21

Test Menu requirements

Answer 21

• Considerable equipment
• Training
• Labor Input
  then Send it to the Reference Laboratory

Question 22

An analyzer that cannot be interrupted during operation

Answer 22

Batch analyzer

Question 23

It can accommodate emergency sample anytime

Answer 23

Random Access (Stat Sample)

Question 24

It is facilitated by load balancing (technique that distributes the work evenly) & (spreads testing over a longer period to better match the instrument)

Answer 24

Continuous Sample processing (Mixed Sample)

Question 25

A fixed # of samples w/ scheduled day & time of test run

Answer 25

Batch Sample (Routine Sample)

Question 26

It provides an opportunity for the staff to participate in analyzing workflow and improving performance and identifies the issues that would not be readily apparent from the data collection

Answer 26

Test ordering patterns / interviews

Question 27

It involves processing special requests such as: troubleshooting incorrect orders, unacceptable samples, and misaligned barcode labels

Answer 27

Orders for add-on tests

Question 28

interviews are particularly valuable to understand what | occurs outside the laboratory

Answer 28

Computer-generated orders

Question 29

Term “Statim” or immediately, perform the test immediately

Answer 29

STAT

Question 30

This should be an ongoing activity where this is undertaken whenever contemplating adding workstations, new technology, or any significant change, and Can be applied to any segment of the laboratory’s workflow whether technical or clerical

Answer 30

Task mapping

Question 31

letter A is the original workflow; B is the improved workflow. The Goal is to improve workflow.

Answer 31

Workflow analysis

Question 32

identifies bottlenecks and impact of staffing

Answer 32

Workflow modeling

Question 33

interferences can be drawn about more efficient processing and testing

Answer 33

Workflow simulation

Question 34

allows a person to analyze the complex interrelationships to better predict the outcome of a given workflow design

Answer 34

Workflow modeling software