Title : Improving stat lab turnaround times by implementing phlebotomy for nurses & patient care technicians
Abstract:
Background:
• The project was originally initiated from a need to decrease STAT lab result turnaround times, and positively impact the large volume of STAT labs being ordered.
• A feasible and sustainable process to support, train and validate phlebotomy skills for Nurses and Patient Care Technicians (PCTs) was sought.
• A pilot consisting of four patient care areas was started in November, 2015 to determine best approaches for engaging Nurses and PCTs in partnership with Lab Phlebotomists.
• The process will be rolled out to all other CUH and Zale patient care areas by 2017.
Aim statement: The purpose of the project is to demonstrate that UTSW Nursing and PCTs can collect STAT laboratory specimens more efficiently and timely for the majority of patients. The overall goal is to improve on or best turnaround times for STAT labs:
• Order-to-Collect Turnaround Time < 30 minutes within four weeks of go-live • Collect-to-Received Turnaround Time = 75% within four weeks of go-live
• Percent Volume of STAT Labs Collected by Nurses/PCTs within 30 minutes or less = 75%
Team: Chito Mendoza, RN, David Barnes, Dawn Brown, RN, Emily Flahaven, RN, Erlinda Young, Francesca Lee, MD, Genelle Brinkley, MT, Jacqueline Coats, RN, James Foster, James West, RN, Joy Daniel, Julie Abraham, RN, Kathy Shook, RN, Lela McAfee, Lisa Dalton, RN, Lori Hodge, RN, Marilynn Bordelon, RN, Nancy Neal, RN, Rachel Faidley, RN, Ruben Castillo, RN, Suzan New, RN, Tiffani Fox, Trish McBean, RN, Tsedey Melaku, RN, William Kirkpatrick
Interventions:
• Venipuncture Skills training
• Enhanced, team-based SunQuest® Collection Manager training
• Improved Nurse/PCT and Lab Phlebotomist communication, coordination, availability and difficult phlebotomy escalation
• Changes to SunQuest® order messaging priority (Nurse Collect vs. Lab Collect)
• Improved feedback to Providers on STAT order logistics (appropriateness, timeliness, etc.)
• STAT pager notifications for faster turnaround time from order to collection
• Hardware optimization and focused troubleshooting (label printers and workstations)
Results:
• Improved overall Nurse & PCT engagement and phlebotomy skills for _____ staff
• Improved use and knowledge of the Collection Manager® system for ___ Nursing & PCT staff
• Improved order-to-received turnaround times (goal of 60 minutes) collectively (RNs, PCTs and Lab Phlebotomists all collecting specimens) by 8%.
• Nurses & PCTs averaged 22% better than goal (47 minutes versus 60 minutes) over 9 months for order-to-received turnaround times.
• Nurses & PCTs average specimen collection volume = 61%, besting goal of 75% in one patient care area, approaching goal in another patient care area, and steadily improving in two other patient care areas.
• Patient Care Areas where Nurses & PCTs collect the majority of STAT specimens have better results turnaround times.
