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Unilabs 2008 16 Sept Capio Case Study: Using Lean and Six Sigma to Advance Integrated Care in the Hospital ”A Journey towards the LEAN Laboratory supporting LEAN Healthcare” Tom M. Pettersson, Ph.D., Head of Development, Capio Diagnostics/Unilabs, St. Görans Hospital, Stockholm, Sweden [email protected] Unilabs 2008 16 Sept We are a leading supplier of laboratory-and radiology services in Europe. We supply diagnostic services – laboratory medicine and radiology services – to public and private health care units, insurance companies, occupational health units as well as to drug development companies. 1 Basic facts about Unilabs Operations in 11 European countries Denmark, Finland, France, Italy, Norway, Portugal, Russia, Spain, Sweden, Switzerland and the UK. Previous Capio Diagnostics No of employees: 3,100 No of radiology examinations: 700,000 Radiology units: 20 CD Stockholm CD Sörmland CD Skaraborg No of mammography screenings: 95,000 Mammography units: 11 No of laboratory medicine analyses: 28 million No of laboratories: 80 Turnover: € 360 M Capio — a pan European company • Leading European healthcare services provider to the public and private sector: – hospitals – primary care – specialist clinics – management contracts • Diverse customer base: – local, regional and national – health authorities Capio Diagnostics Capio Healthcare – insurance companies At StGörans Hospital – private customers • Only industry player with a real multi-country presence in Europe • 16,500 employees • 2006 turnover CHF 2,210 million (SEK 13,000 million) TP20071016 - 02 2 The HealthCare Value Stream Increasing Pressure Demand ”More For Less” Patient ”Third HC Laboratory IVD / MD / IT “The HC Party Providers Services Industry Consumer” Payer” Our Piece Process LEAN Healthcare LEAN Six Sigma LEAN In Product Six Sigma Six Sigma Design in HealthCare ISO? / QMS Towards the LEAN Laboratory 1999 ……….. 3 Planning, Realizing and Evaluating a Modern Clinical Information Production Site - 1999 at StGöran Pre Load Stand Analyze Unload Validate Centrifuged Tray Download Request to In In Pre labelled Alone Adv 1650 and And Centra Link Centra Link Unique Decap Adv Centaur Sort identity Loader LIS MW WC, LM Method POCT Sample Consolidation Manager ADVIA ie Emergency W Centaur • Routine Samples O Cardiac Markers ADVIA Biochemistry R on Stratus CS 2400-1 • TDM K • DOA ADVIA • Proteins ADVIA C Centaur 2400-2 • Tradclinchem E L Immunochemistry Pat/Dr Sample Analyze Decision Immulite L • Allergy 2500 • Infectious disease Advia WorkCell Serology Siemens Medical Solutions Diagnostics • Autoimmunity Bayer HealthCare / SIEMENS TP20071016 - 09 Effects of Work Cell Process Medical Benefits Efficiency and Staff Satisfaction • Improved Working Environment • Focus on Medical Value and Service • Integrated Reports improves Timing 20,000 Transfer in Decision Process 3,500 Tubes /D Changing of Tubes /D • Improved reproducible TAT the Working 12,000 Transfer Environment of Tubes /D • Improved Quality and Medical Security most (less error) important 8,000 Transfer 2,500 Tubes /D Effect !!! • Increased Focus on Clinical Value of Tubes /D 30 % Reduction 60 % Reduction in Number of Tubes in manual Work Process oriented production Reorganisation of Staff Integrated Sample Reception, Registration, Sample Distribution Pathology C o n s o l i d a t I o n o f w o r k p r o c e s s e s coag coag hem rc /ic glu rc hem remc urin Team rc rc allergy rem micro rc iccm serol rem Micro Sample reception/sortings SR drugs Cultiv. Team Stat lab Analytical Sample Flows Team Training SR ADVIA 1650 x2 Sample Coagulation Coag Hemat. W Storage Of O Bloodgas Load/ Sort Team R Hematology Multidisciplinary ADVIA K External lab “Single Work Team” HbA1c Centaur C Team Toxic E KSS Clin Chem ADVIA L KSS Micro Routine biochemistry Centaur L MSE Clin Chem Urine BFolate Team (spec) KS, HS Immunochemistry GC Team Elisa/ Protein/Electrophoresis Elecsys Elpho. 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