roponin turnaround time (TAT) statistics at St. Luke’s Laboratory’s Emergency Department (ED), Cedar Rapids, IA, hit an all-time low in January 2010. January had been a hard month because of the implementation of new Core Lab instrumentation. Three chemistry platforms had been removed and replaced with two new platforms. In a two-month period, chemistry instrumentation had a complete overhaul. But, despite ongoing efforts, little improvement was seen in TAT statistics in February and March. At that point, St. Luke’s Lab ED staff began to refocus it efforts to meet its TAT goals.
In April, Angie Farmer, Central Collection supervisor and Suzanne Felton, Core Laboratory supervisor, brainstormed ways to improve the troponin TAT and came up with a project they dubbed “Team Troponin.” The two women set the number of minutes for what — in TAT time — would be considered a strikeout, a single, a double, a triple, or a home run. Three components of the TAT cycle were measured: order to collect, collect to receipt, and receipt to result.
This data was entered daily on the laboratory’s “Wrigley Field” poster board, so that all participants could see how Team Troponin was doing. Upon achieving a “Grand Slam” on May 7, 2010 — the day the team made a home run for all three of the measured components of that TAT cycle — everyone celebrated with a baseball-themed luncheon, munching on hot dogs, peanuts, nachos, and other ballpark food.
Besides the focused effort on TAT, few things changed in the daily lab practices. Two new STAT centrifuges were implemented, as well as a policy that allowed the dispatch of a second phlebotomist to the ED if three patients were there to be drawn, which helped decrease the pre-analytical time.
As time went on, Team Troponin kept hitting Grand Slams and “high-fiving” key players in the ball game. Every month, team members were elated to see TAT statistics continue to reach new heights — even though their efforts were focused on troponin, they saw all the ED TAT statistics improve.
In July 2010, the hospital recognized the laboratory for its efforts and awarded its personnel the St. Luke’s Spirit Cup — a traveling trophy for departments impacting patient care. Despite this gesture, the lab team did not stop there! Team Troponin continued to improve month after month; and in December 2010, it achieved its best statistics ever. In all, St. Luke’s lab team had 19 Grand Slams in 2010. The biggest achievement of this whole project was that a previously low troponin TAT got turned into a competition that the ED lab staff could enjoy, but that in the end, the team’s players agreed that their patients were the real winners!
Suzanne A. Felton, MT(ASCP), is the Core Laboratory supervisor at St. Luke’s Hospital in Cedar Rapids, IA.