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Clinical PathologyQuality Dashboard
January 2010
Clinical Pathology Quality Dashboard
Inpatient Phlebotomy First AM Blood Draws
0%
20%
40%
60%
80%
100%
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2008 2009
University Hospital
8am
9am
10am
Drawn by
0%
20%
40%
60%
80%
100%
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2008 2009
Mott Hospital
8am
9am
10am
Drawn by
Clinical Pathology Quality Dashboard
Inpatient Phlebotomy First AM Blood Test Results:
PT/PTT, CBCP, and Comprehensive Panel
0
100
200
300
400
0%
20%
40%
60%
80%
100%
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Av
g D
ail
y V
olu
me
2008 2009
University Hospital
8am
9am
10am
Results by
0
2
4
6
8
10
12
0%
20%
40%
60%
80%
100%
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Av
g D
ail
y V
olu
me
2008 2009
Mott Hospital
8am
9am
10am
Results by
Inpatient Phlebotomy Draws
Clinical Pathology Quality Dashboard
19,75920,459
19,598 19,795
21,992 21,71420,986
21,65122,073
22,675
20,208
22,942
21,65020,940
0
5,000
10,000
15,000
20,000
25,000
30,000
Nov Dec Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec
2008 2009
0
200
400
600
800
1000
1200
1400
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Mo
nth
ly V
olu
me
2008 2009
Emergency Department Cardiac MarkerVolume and Turnaround Time
> 2 hours
1-2 hours
<1 hour
TAT
Clinical Pathology Quality Dashboard
Turnaround Times
Point of Care service began
0
20
40
60
80
100
120
140
160
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Mo
nth
ly V
olu
me
2008 2009
CSF Gram StainVolume and Turnaround Time
> 1 hour
30 min-1 hour
<30 minutes
TAT
Clinical Pathology Quality Dashboard
Specimen Processing Turnaround TimeAverage Daily Turnaround Time + 1 standard deviation
for Inpatient Specimens going to Chemistry
September 2006 - July 2007
0:00
0:14
0:28
0:43
0:57
1:12
Sep-06 Oct-06 Nov-06 Dec-06 Jan-07 Feb-07 Mar-07 Apr-07 May-07 Jun-07
Tu
rnaro
un
d T
ime i
n M
inu
tes
0:00
0:14
0:28
0:43
0:57
1:12
Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09
Tu
rnaro
un
d T
ime in
Min
ute
s
January 2009- December 2009
Clinical Pathology Quality Dashboard
Molecular Diagnostics Laboratory
0
1
2
3
4
5
6
7
8
9
10
0
200
400
600
800
1000
1200
1400
January 2002
July 2002
January 2003
July 2003
January 2004
July 2004
January 2005
July 2005
January 2006
July 2006
January 2007
July 2007
January 2008
July 2008
January 2009
July 2009
TAT
(day
s)
Spec
imen
s R
ecei
ved
per M
onth
Month/Year
Specimens Received and Turnaround TimeJanuary 2002 - December 2009
# Specimens TAT Linear (# Specimens) Linear (TAT)
Clinical Pathology Quality Dashboard
Chemistry In-Lab Turnaround Times
0
5
10
15
20
25
30
Pe
rce
nta
ge
Sep 07 - Dec 09
Sample Turn-Around Time
Routine >60 min stat >45 min In pt. stat >45 min out pt. stat
UMHS Blood Product Utilization
Clinical Pathology Quality Dashboard
0
1000
2000
3000
4000
5000
6000
7000
8000
0
1000
2000
3000
4000
5000
6000
7000
8000
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Pa
tie
nt
Po
pu
lati
on
2008 2009
Blood Product Utilization
Random Platelets
Allo RBC Units
Plasma Units
Cryo Units
Partial Units
SD Platelets
AdjustedDischarges
Units Used
1.3
1.4
1.5
1.6
1.7
1.8
1.9
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2008 2009
Crossmatch/Transfusion Ratio
Threshold
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2008 2009
Wasted RBC
Threshold
0%
1%
2%
3%
4%
5%
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2008 2009
Wasted Platelets
Threshold
0%
1%
2%
3%
4%
5%
6%
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2008 2009
Wasted Plasma
Threshold
0%
5%
10%
15%
20%
25%
30%
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2008 2009
Wasted Cryoprecipitate
Threshold
Clinical Pathology Quality Dashboard
CAP Proficiency Testing
2nd Quarter FY 2010
Clinical Pathology 126 = Number of Challenges 98% = Satisfactory ResultsAnatomic Pathology 0 = Number of Challenges N/A = Satisfactory ResultsDepartment Total 126 = Number of Challenges 98% = Satisfactory Results
100
9799.5 99 100
92
99 98
50
60
70
80
90
100
0
100
200
300
400
500
600
3rd Qtr 4th Qtr 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr 1st Qtr 2nd Qtr
Per
cen
t S
atis
fact
ory
Nu
mb
er o
f C
hal
len
ges
Clinical Pathology Scores
FY2008 FY2009 FY2010
Clinical Pathology Quality Dashboard
CP Financial Measures
0
2
4
6
8
10
12
1.00
1.05
1.10
1.15
1.20
1.25
1.30
1.35
1.40
1.45
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Blo
od
Pro
du
ct U
nit
s (t
ho
usa
nd
s)
Do
llars
(m
illio
ns)
pai
d t
o S
E
Mic
h A
mer
ican
Red
Cro
ss
2008 2009
Blood Costs vs. Total Blood Products Used
Units
Cost
$4
$5
$6
$7
$8
$9
$10
$11
Clinical Path Expense per Test*
* Excludes Blood Bank and Phlebotomy
275000
300000
325000
350000
375000
400000
425000
1,000
1,200
1,400
1,600
1,800
2,000
Tota
l Tes
ts
Test
per
FT
E
Clinical Path Tests per FTE and Total Tests By Month
Tests per FTE Total Tests
• Update of Clinical Laboratories Reflexive Testing List
• Formal Clinical Pathology Operations
Committee established
• 22 Sendout and/or highly esoteric tests were vetted in the laboratory Formulary Committee during 2009
Clinical Pathology Quality Dashboard
Clinical Laboratory Operations Initiatives
• Establishment of new Outpatient test option that reflexively orders a urine culture based on selected urinalysis results
• Standardized and clarified reporting of fecal
occult blood testing results and completed • Dr. Lina Shao (Cytogenetics) joined the
Department of Pathology
Clinical Pathology Quality Dashboard
Clinical Laboratory Service Enhancements
• Congratulations to Chemistry and Microbiology; NO CSF Gram stains have taken more than 1 hour to complete – for two consecutive months
• CAP Proficiency Testing Performance for FY10 second quarter – was outstanding! (98% satisfactory results on 126 challenges)
• December, 2009 marked the “best ever” performance in Mott Hospital AM blood draws completed before 10 AM
Clinical Pathology Quality Dashboard
Kudos