Medical Lab Benefits from Qmatic's Advanced Patient Management Capabilities

Background
Brooke Army Medical Center (BAMC) is a level-one trauma center, located at Fort Sam Houston, just on the northeastern edge of San Antonio, Texas. BAMC is an ultra-modern facility, dedicated to using the latest technology in many areas. The BAMC Commander manages and coordinates activities related to the medical readiness of active Army, National Guard, and Army Reserve medical units. The medical center supports the health care services provided to a population of more than 573,000 active duty soldiers, their family members, and retired service members and their families.

Situation
Jeri Cruz is the Specimen Processing Supervisor who oversees a lab that employs both military and civilian workers. Cruz' department is responsible for ambulatory patient specimen collection and processing for the Department of Pathology and Area Laboratory Services (DPALS).

Quality is the top priority for DPALS. Test results from all sections are continuously monitored for reliability, precision, and accuracy by both internal and external quality control programs. The laboratory’s accreditation, licensure and other inspections include: Joint Commission for the Accreditation of Health Care Organizations (JCAHO), College of American Pathologists (CAP), and Department of Defense Clinical Laboratory Improvement Program, among others.

There were approximately 60,000 Phlebotomy visits each year from 2001-2003. Wait times to see a lab specialist averaged 30-45 minutes, which led to overcrowding in the waiting area. During peak periods, wait times would go as long as one hour. The situation led to poor patient satisfaction reports and disgruntled employees. It also meant that required Standard Operating Procedures goals were not being met.

Solution
COL Robert D. Ranlett - the Chief of the Department of Pathology - along with Linda Speights (Chemistry Supervisor), led the push to completely revamp the process to make the department more patient friendly. QMATIC was installed in 2004 as a part of the makeover in the hope of achieving lower patient wait times, and improved patient and employee satisfaction.

When patients enter the Specimen Processing Department, they are directed to a QMATIC printer and receive an alphanumeric ticket.

"Military In Uniform" is for soldiers on duty who must be processed quickly and returned to their posts. There is also a "Drop Off Specimen Only" selection for those who require no personal consultation. Three service categories are offered. The "Routine" button is for patients who have come in for standard blood draw.

After selecting the appropriate category, the patient is given a number and proceeds to the wait area. They are then queued into the Qmatic system that notifi es the front desk greeters of their presence and tells the employees what category each patient has selected.

Visual displays are located throughout the lobby and can easily be seen from any seat in the room. The patient waits for their number to be displayed or called through the Qmatic voice notifi cation system. Patients, once called, are either brought to the front desk or to the processing area where a technician is ready for their arrival.

Q-WIN provides BAMC with statistical information that identifies wait times, patient needs and details exactly how long it takes patients to move through the Specimen Processing Department. This information is available on a daily, weekly and monthly basis.

MAJ Gregory A. Johnson (Chief, Pathology Support), SSG Christopher Schkerke (NCOIC of Specimen Processing), and Cruz review the monthly stats that relate to patient wait time. "We realize we are probably only using one-tenth of the statistical information that is available with Qmatic. We want to learn more about the reports capabilities, and we will. The categories work great for us and we look forward to getting as much out of the system as we can," Cruz says.

Results
Before Qmatic, the average wait time to see a phlebotomist was 45 minutes. However, this number did not include how long patients were waiting to get to the front desk nor did the average meet a benchmark of 95 percent compliance in meeting the Army Medical Command standard the department follows.

Since Qmatic has been in place, the total average wait time has fallen to 10 minutes or less. The department has even determined that after the patients check in at the front desk, they wait an average of three minutes before they are seen be a phlebotomist. Compliance has risen to 99.64 percent. Total patients seen rose to 94,700 in 2004, a considerable change from 60,000 in 2003.

The department now handles 33% more procedures with the same amount of staff and in the same space they had before Qmatic. "Patient satisfaction went through the roof," according to MAJ Johnson. The department has received numerous accolades from management and those they serve.

Before Qmatic, the department received an average of 10-15 complaints a month. Since the implementation of Qmatic, the department now receives 10-15 patient compliments every month. Only one complaint (out of 90,000 patients) has been received in the last year. Employees’ attitudes are very positive; they feel empowered, more organized and better able to communicate with their patients.