Applying the "queueing theory" to preanalytics may be your silver bullet
by Dennis Ernst • February 26, 2021
A recent article in Forbes tackled two problems facing many phlebotomy services across the healthcare spectrum: long wait times for outpatients and slow turnaround times for all patients.
The author, a Senior Director of Client Services for LeanTaas, details an impressive and logical approach to predicting peak demand for phlebotomist- and nurse-draws based on the "queueing theory," which has been around a long time, but never applied so applicably to the preanalytical process. Researchers mentioned in the article realized the critical consequences of delays in what they refer to as the "end-to-end cycle time" (i.e. that from extracting the blood sample to posting the results). They are discussed as being much worse than a source of irritation for patients, but contribute to a significant and adverse impact on downstream operations including prolonged occupancy of emergency department beds, delayed discharges from nursing wards, and delays in medication decisions and administration.
Decreased wait times for outpatients is even more critical today to minimize exposure to other patients, some of whom may be infectious with Covid-19. So it's obvious why managers should be more concerned about addressing these problems that have been plaguing the industry for decades. Many managers may have given up on ever finding a permanent solution and accepted long wait times and turnaround times as unfixable. Such a surrender is no longer acceptable.
The author identifies the root cause of these delays as the result of attempting to match the incoming stream of patients with a fixed number of blood-draw personnel (dynamic versus demand). I'm not going into the details, but it makes perfect, logical sense. (I've linked to the article at the end of this post so those of you with management responsibilities can benefit fully from what seems to me to be a hopeful strategy.) The article criticizes the conventional approach to process improvement in too many facilities, i.e., establishing the number of staff members needed for each hour of the day based on the average number of patients in each hour and the average duration of a typical draw.
I know what you're thinking. That makes pretty good sense... until you read the article. They compare such a calculation as equivalent to putting your feet in a freezer and your head in an oven, then concluding your average body temperature to be just about right.
The alternative "queueing theory" is not new, but it's application to the preexamination process where patient and physician satisfaction often plummets has never been so artfully discussed. Take a look. I think you'll find some nuggets here that give you hope and your workflow some long-overdue improvements.
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