Bassett Health Network

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Executive Summary

Reconfiguring Laboratory Workflow to Increase Efficiency

When Bassett Health Network, a large healthcare organization covering 5,600 square miles in upstate New York, invested in new instrumentation for its core laboratory and seven additional facilities, it also sought to expand the value of the new systems through workflow optimization. Through partnership with Beckman Coulter, Bassett Health Network was able to apply a 3P (Product, Preparation, Process) methodology, transforming operations to increase standardization and reduce redundancies. The strategic approach resulted in increased efficiencies that included a 65% reduction in process steps, a 71% reduction in touchpoints, and a volume increase at the core laboratory of approximately 20%.

Bassett Health Network recognized that taking full advantage of the value of its new chemistry and automation instrumentation would require a redesign of laboratory space for optimal workflow. Desiring to integrate all network sites into one cohesive laboratory service line, while streamlining processes and minimizing sample handoffs, touchpoints, physical steps and queues, Bassett Health Network sought solutions to: 

• Create a continuous flow through central lab processing and send-outs, and chemistry, hematology, immunoassay and urinalysis testing
• Optimize automation line location and connections at the core laboratory
• Define the optimal workflow for sample processing, staff workstations and instrument layout at O’Connor Hospital and AO Fox Hospital laboratories

• Implementation of new immunoassay and clinical chemistry analyzers
• Core laboratory in Cooperstown: Two DxC 700 AU clinical chemistry analyzers and two DxI immunoassay systems
• Cobleskill Hospital, Little Falls Hospital, O’Connor Hospital, Fox TriTown Campus and AO Fox Hospital: One AU480 clinical chemistry analyzer and one Access 2 Immunoassay system at each site
• Fox Care Cancer Center Laboratory and Herkimer Health Center Laboratory: AU480 clinical chemistry analyzers 
• REMISOL Advance data management system 
• Power Express laboratory automation system at Bassett Medical Center site
• 3P to optimize workflow

• Reduced core laboratory FTEs by two
• Increased consistency in overall TATs by reducing variation 
• Reduced process steps by 65%
• Decreased touchpoints by 71%
• Increased testing volumes in the core laboratory by approximately 20% with no additional resources
• Reduced the instrument footprint at O’Connor Hospital and AO Fox Hospital laboratories by 50%

As Bassett Health Network began a network-wide evaluation of chemistry instrumentation, laboratory leaders knew that to guarantee success and enhance patient care, they would need to ensure complete system implementation. They further realized that instrumentation is only part of the equation and that to take advantage of all the efficiencies of a system, they would need a fully engaged partner. They looked to Beckman Coulter and the Danaher Business System for solutions as to how to improve laboratory productivity.

What is 3P?

The 3P methodology is a tool intended to optimize the flow of work in order to reduce steps, making the work easier for laboratory associates to interact with their analyzers.

Shifting the culture through 3P engagement

To support the goal of network cohesiveness and integration of the sites, Bassett Health Network used the 3P methodology to communicate the coming changes and ensure everyone was aligned. Bringing all parties together to discuss new operational models was one of the first benefits the team saw in laboratory process improvement. 

The 3P engagement approach was also beneficial as the network moved to a more integrated rapid response model that would reduce test menu redundancies and shift some tests to other sites. Giving team members ownership and autonomy over the layout and implementation of instrumentation, as well as workflows, empowered them to positively impact operations in their individual laboratories.

Establishing timelines through 3P strategies

The teams worked together to generate a cohesive output plan for moving ahead with the project. Using 3P techniques, staff members worked toward the goal of project implementation, developing a strategy that addressed both the macro-, as well as micro-, level planning. 

Building consistency through a standardized middleware solution

Enhancing efficiency at Bassett Health Network required standardization. A total of eight laboratories changed instrumentation, so that all would share the same LIS system. This gave all sites the same test build, methodology and reference ranges. This was critical to assure continuity of care as patients can present to any of the facilities in the network. The test menus were also standardized so all the subsidiaries had comparable rapid response menus, and the routine work could be routed to the core lab at the medical center. This consolidation of testing lowered the overall cost per test due to the economy of scale, while assuring the appropriate STAT testing was available in all facilities.