A chemotherapy clinic was experiencing significant delays in delivering treatment to waiting patients. Scheduled appointments were missed. Patients were stressed and in some cases belligerent with clinic staff. Patients, nurses and administrative staff were not happy and wanted the situation resolved.

Upon investigation, the situation centered around delay in the clinic receiving blood test results from the central blood lab, who serviced the entire hospital. Blood samples taken on the patient's first visit to the chemo suite, are sent to the blood lab using a pneumatic tube system. Chemo treatment could not begin until a blood sample had been tested and the results showed that the chemotherapy could be delivered safely.

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On any day, test results could take hours which delayed treatment delivery. There was a real push to install a blood lab right in the chemo suite as way to get samples analyzed and results communicated more quickly. The blood lab would cost hundreds of thousands of dollars and would then have to be staffed with scarce nursing and administrative staff. 

Upon closer investigation, it was discovered that serious delays always seemed to occur during the same time period  each day, which in turn backed up and delayed lab output for the remainder of the day.

It was decided to run a two- hour problem-solving session with a multi-disciplinary team involved in the process. The participants were nurses responsible for taking the blood sample, the admin person responsible for sending the sample and the lab technician responsible for testing the sample. 

During this problem-solving session it was discovered that the chemo suite ran out of pneumatic tube carriers mid-morning and therefore stopped sending blood samples until sent carriers were returned. Extra pneumatic carriers had been acquired but that did not fix the problem. The blood lab technician commented that the blood lab waited for a porter to manually distribute the tubes back to the various departments late morning.

 

It was possible however, to use the pneumatic system to return the carriers immediately, but the lab didn't know who to return them to. The team decided to put a blue dot on the chemo clinic pneumatic carriers so they could be immediately returned. Once implemented this solution significantly reduced the congestion and resulting delay in the chemo clinic providing needed therapy to patients. 

The team rightly defined the problem to be, how to return chemo clinic carriers immediately after removing the transported blood samples, rather than waiting for a porter to deliver them.  A problem that could be quickly solved as opposed spending a lot of money on acquiring and staffing a new blood lab. Define the problem properly and you will get a solution that works.