Blood Test
The ED nurse is typically in charge of drawing the blood for the tests and arrives as soon as the doctor leaves the room. After giving any necessary medications he starts the process of collecting blood which is 20% of his job description. To do this, he requires several supplies such as gloves, tubes and needles that are not readily available in the patient room (for sterility and safety reasons). Medline Industries is the primary surgical suppliers to the Burton Group. They currently supply gloves, scrubs and other medical supplies on a monthly basis. Materials management staff stock up the ED supply room once or twice a week or when ED nurses call them if they run out of supplies.
The nurse usually walks to the "supply-room" located down the hallway to collect these supplies. It takes 5 minutes for the nurse to travel to the supply-room, find the supplies and walk back to the patient room. As one nurse suggested, "It is not about the availability of these supplies. We always have tons of inventory but usually not the right ones! Also it is hard to find where everything is." In one instance the quality team observes that the medium-sized gloves were missing and the nurse had to settle down for a large-sized glove. In another instance, a flash light was not working and the nurse could not find the batteries in the supply room. He walked toward a hidden cabinet near the supply room and took out the batteries he had hoarded for occasions like these. These inventory issues create frustration among the nursing staff which sometimes is reflected in their interactions with the patients.
After gathering all the supplies, the ED nurse walks back to the patient room. He sets up the supplies on a cart which takes 2 minutes and then draws blood in the tubes. Normally the ED Nurse would use the pneumatic tube system to transport the tubes directly to the lab. However, for the last 2 weeks the system was broken so he walks to the lab located at the far end of the hallway. The facility management staff seems to be busy with fixing broken equipment. There is no scheduled preventive maintenance for hospital equipment. The actual process of drawing blood (once the supplies are available) and transporting the samples to the lab takes 10 minutes. If thepneumatic tube system were working, the process would take only 5 minutes. The nurse documents the information in the EMR. The reports generated by the lab can be accessed in the EMR when ready.
Not all patients with simple fractures need a blood test. However to save time later some nurses proactively collect blood just in case the doctor orders them later. The quality team observed that the doctor does not order blood tests for most patients.
Q1. Calculate the process time for the Blood Test Step
Q2. Calculate the FTE and cycle time
Q3. Calculate Value Added and Non Value Added Time
Q4. Provide at least 4 Suggestions for improvement