Authors (including presenting author) :
Lee KC(1), Chan YM(1), Tang SK(1)
Affiliation :
(1)Nursing Services Division, United Christian Hospital
Introduction :
From 2017 to 2019, there was 5.5% increase in demand of in-patient phlebotomy services in United Christian Hospital (UCH), and an escalating trend was anticipated. Achieving performance pledge with tasks completed within targeted time became difficult. A delay in availability of inpatient test results may lead to delay in patient management and discharge. In order to optimize the huge service demand, uphold patient’s safety and facilitate patient discharge, ‘STEM’ strategies were adopted in managing phlebotomy services since 2017. There was an utmost need to review its effectiveness and explore if any service gaps were identified.
Objectives :
To evaluate the effectiveness of ‘STEM’ strategies on improving efficiency of inpatient phlebotomy services.
Methodology :
Smart • In align with smart initiative of Hospital Authority, smartphones were used to replace pagers to receive automated dispensing system calls in a timelier and clearer manner. Priority of task was customized and displayed according to its urgency. Teamwork • Democratic leadership style with effective communication skill was demonstrated by phlebotomy in-charge. Committed staff and a trusted and collaborative team was engendered, thus promoting teamwork and productivity. Equipment • On-Ward-One-Equipment was achieved. Ward-based electrocardiogram (ECG) machine and phlebotomy trolley were established and a standard layout for each trolley was agreed to maximize efficiency. • Job-sheet cabinet was standardized. A 4-layer cabinet with job-sheet separated according to its urgency, nature and expected time of completion was designed for all inpatient wards so as to minimise risk of errors and save time in task sorting. • Disposable ECG electrodes and Easi-clips were used. They not only improved infection control, but also increased efficiency as traditional bulb electrodes were easily dislodged hence affecting quality. Method • A new demand-driven staffing model was designed using LEAN management. Adopted principles included reallocating manpower according to service demand and reduced unnecessary walk without additional resources.
Result & Outcome :
After implementing the ‘STEM’ strategies, 390 staff-hours was saved annually from transportation to task completion. As a consequence, mean performance pledge achieved in 2019 was increased by 9.27% and 37.47% in normal and pre-placed orders respectively when compared with 2017 despite of 5.5% increase in workload with manpower remained unchanged. Although a higher productivity was achieved, incident rate was dropped by 60%. This revealed that ‘STEM’ strategies could effectively improve the productivity while upholding safety of phlebotomy services.
