title: Providing critical laboratory results on time, every time to help reduce emergency department length of stay: how our laboratory achieved a Six Sigma level of performance.
abstract: OBJECTIVE
  To develop a fully automated core laboratory, handling samples on a "first in, first out" real-time basis with Lean/Six Sigma management tools.
  
  
  METHODS
  Our primary goal was to provide services to critical care areas, eliminating turnaround time outlier percentage (TAT-OP) as a factor in patient length of stay (LOS). A secondary goal was to achieve a better laboratory return on investment.
  
  
  RESULTS
  In 2011, we reached our primary goal when we calculated the TAT-OP distribution and found we had achieved a Six Sigma level of performance, ensuring that our laboratory service can be essentially eliminated as a factor in emergency department patient LOS. We also measured return on investment, showing a productivity improvement of 35%, keeping pace with our increased testing volume.
  
  
  CONCLUSIONS
  As a result of our Lean process improvements and Six Sigma initiatives, in part through (1) strategic deployment of point-of-care testing and (2) core laboratory total automation with robotics, middleware, and expert system technology, physicians and nurses at the Oklahoma University Medical Center can more effectively deliver lifesaving health care using evidence-based protocols that depend heavily on "on time, every time" laboratory services.
authors.affiliation: Department of Pathology, Oklahoma University Health Sciences Center, PO Box 26307, Oklahoma City, OK 73190, USA.
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Blick
mesh_terms: D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007755:Laboratories, Hospital / Q000458:organization & administration / Q000592:standards*; D007902:Length of Stay; D011785:Quality Assurance, Health Care; D012984:Software
keywords: Automation; Lean; Length of stay; Robotics; Six Sigma; Test turnaround time