HealthCare Global Enterprises Ltd., the specialist in cancer care has its headquarters in Bangalore, India and is known to be the only dedicated cancer care network. Triesta, a subsidiary of HCG, provides world-class diagnosis at its pathology labs. The laboratory decided to “change for better” based on patients (Chemotherapy and Radiotherapy patients who came from outside Bangalore) and clinicians feedbacks….delays in receiving reports, increased length of stay and more.
Process challenges for laboratory included.
- Large pre analytical waiting times due to lack of organized work flow and work cell, sample batching, lack of standard work and,
- Staff challenges due to inefficient level loading and poor motivation.
Patient grievances and clinicians complaints combined with staff attrition made the laboratory management take stock of the situation. The laboratory management presented and discussed this project with the hospital management. The hospital management approved the project in view of its effect on improving service quality, reducing risk exposure, improvement in employee's quality of life and optimum utilization of laboratory space.
Patient’s feedbacks (such as the ones given below) were analyzed, that triggered the management to evaluate the situation further.
Feedback: Patient, for chemotherapy, had given the blood sample towards the end of day and was informed that the report would be ready on a ‘D’ day. The patient planned everything including a follow up appointment with his doctor, stay at Bangalore (Patient, outside Bangalore) with a hope that treatment would start soon and he will be relieved from pain. The patient arrived at the lab claiming for the report on the said “D’ day, only to be informed that ‘report would be ready only tomorrow’. ‘Why???’, The sample was received after cut off time of the laboratory and was taken for processing only the following day and estimation of ‘D’ day was wrongly misinterpreted. ‘Can you make the report possible today? We have come a long way’. Laboratory staff had a ready answer, ‘As per our laboratory policy, this report takes time. Nothing else is possible’. The patient said, “Do not hide behind your policies. Your policies are not helping us”.
That’s when the management realized that policies are only written for accreditation purposes and are not patient friendly. Thus the leadership team decided to address the issue of patients and staff and played an active role in implementing the required changes.
A project team formed. Regular meetings happened between the management and project team. A team of six people was formed to take the project forward. The team lead by the laboratory director also included the lab manager Mr. Vinay, quality manager Mr Rajendra Kumar, two technical staff Mrs. Saroja, Mr Devendrappa and the hospital nominated Dr Prathiba who is GM operations HCG hospital.
Results: In-depth analysis of every process step related to patient samples helped correct the work flow and 30 % reduction in TAT, staff shifts and recruitment of skilled staff to fix vacancies. This helped achieve good level loading and staff morale.
Lessons Learned
- Things can be improved if it is measured correctly