The Crimson Press Curriculum Center

First Page and the Assignment Questions:
"They're your people!" thundered Bob Grimaldi, supervisor of the chemistry department at New England Medical Center (NEMC).

The reason why we have such poor laboratory specimen turnaround is because your staff are unprofessional. They're more concerned about having a good time than they are about their work. And I'll tell you, it's impacting patient care. Some of those blood samples sit needlessly in your area for hours and they're spoiled by the time they reach the lab for testing. If it were my department, I'd get rid of them all and start over with a new crew that was dedicated to getting the job done. This can't continue! I want a solution to this problem and I want it fast!

Grimaldi stormed out. As his words sank in, Jim LaBrie, manager of the lab's Central Receiving Area (CRA), knew that something had to be done. Could Grimaldi be right? LaBrie had always been pleased about the high morale in CRA. Could it be that his staff were really just having a good time?

BACKGROUND

   Founded in 1796 as the Boston Dispensary, New England Medical Center (NEMC) was one of the premier teaching hospitals in the Boston Area. Affiliated with Tufts University Medical School, NEMC was located in downtown Boston, near Chinatown and the city's dwindling but infamous "Combat Zone." The 480 bed hospital had over 18,000 admissions and 327,998 outpatient visits in 1992.

   The NEMC Pathology Department consisted of two sub-departments: the clinical and anatomical areas. Anatomical pathology analyzed tissue specimens and performed procedures such as autopsies and surgical biopsy evaluations. Clinical pathology comprised the laboratories, which analyzed blood, body fluids, feces, and urine for a variety of biological factors. The three main laboratories within clinical pathology were chemistry, hematology, and
microbiology.

   The laboratories within clinical pathology performed over 4,000 tests per day. CRA, which was located on the third floor near the clinical laboratories (Exhibit 1), received specimens from various parts of the hospital, entered the requested tests into the lab computer, and delivered them to the appropriate laboratories for testing. CRA acted as a liaison for the laboratories to the rest of the hospital, receiving and preparing specimens, maintaining the laboratory computer system, drawing blood for both inpatients and outpatients, and providing information such as test results to physicians and nurses.

   NEMC had recently embraced the concepts of Total Quality Management (TQM), and by 1992 there were 50 TQM teams involving 300 managers and supervisors actively working to improve NEMC's health care delivery systems. Jim LaBrie was one of the managers involved with TQM. He was also enrolled in the Health Care Management Program at Boston University's School of Management, where TQM concepts were woven throughout the curriculum. He decided that the first step toward solving the problems in CRA was to collect time/motion study data on specimen processing and waiting times.