Question

Can you please answer the 5 questions based on the case study.

Reference book: Laboratory Management.

fr CaseD Decision Making and Process Improvement Study You are the manager of a clinical laboratory at a mid-size (200-bed) commu hospital. Physicians and nurses are concerned about the turnaround time laboratory tests ordered on early morning rounds. It appears are collected by the phlebotomy team on the 6:00 A.M. rounds. Physicians begin their patient rounds at 7:30 A.M. The physicians prefer to review the results of the laboratory tests ordered at the time they see the patient. They explain to you that they cannot make decisions with regards to further patient treatment or discharge without these results. Time is of the essence, as the hospital is cutting the budget, and it is important to decrease the patient length of stay. You are expected to look into this matter and make recommendations regarding the most efficient and effective way to address this problem. for that the samples Issues and Questions to Consider: 1. What is the best method of addressing this problem? 2. What management techniques/styles might be used? 3. Who should be included in a team assigned to address this issue? 4. What decision traps might be encountered and how can they be avoided? 5. What decision-making tools would facilitate the analysis of the problem?

Answer 1

1. The root cause of the delayed turnaround time is the fact that the samples are taken at 6 am, the test and analysis of the samples must be done in the 1.5 hour time gap and the reports must be ready with the physicians when they are at the early morning rounds at 7:30 am. The 1.5 hour cushion time is quite tight and constrained to facilitate effective analysis of the sample and hence accuracy can also be compromised. Also the early morning rounds cannot be delayed much as the course of treatment will be dependent on the physician’s analysis in those rounds.

There are 2 alternatives available in such a scenario:

• Prepone sample collection by 1 hour
• Postpone physician’s early morning visits by half hour

The hospital management needs to check the feasibility of each option before taking the final decision.

2. The decision tree statistical technique can be used to evaluate the various alternatives available to the hospital management and to select the best alternative. The decision tree analysis is quite appropriate as it considers the various risk factors associated with the various alternatives as well, before making the final choice.

3. The various stakeholders of the system must be involved in the decision making process. The perspective and interest of each stakeholder must be considered before deciding upon the plan of action to be followed. The various stakeholders, in this scenario, will be:

• Physicians
• Laboratory staff
• Nurses collecting the sample
• Hospital management
• Patients

4. The various decision traps which can be encountered in the given system are:

• Overconfidence trap: The team may become over ambitious and may make the schedules quite tight for sample collection, analysis and generation of reports
• Prudence trap: The team may become overcautious, and thus devote more time for the process, thereby increasing TAT
• Status quo trap: The team may offer resistance to any kind of process change and hence they would try to maintain the status quo

To save the team from the above-mentioned decision traps, the team must conduct comprehensive analysis of the situation and contemplate the various perspectives of stakeholders before arriving at the final decision.

5. Decision making tools which can facilitate the analysis of the problem are:

• SWOT analysis of the system: The strengths, weaknesses of the system can be analyzed and accordingly decisions can be taken to facilitate the strength and work on the weaknesses
• Feasibility study: to analyze the feasibility of each alternative
• Market research: to identify the best practices prevalent in the industry