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… that was then,

… that was then,. this is now!!!!!! (…this story is based on real life accounts of the transformation of the PR Department of Health Sexually Transmitted Diseases Lab) Francisco Dávila Toro, MD Director STD LAB PRPHL DOH. Introduction.

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… that was then,

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  1. …that was then, this is now!!!!!! (…this story is based on real life accounts of the transformation of the PR Department of Health Sexually Transmitted Diseases Lab) Francisco Dávila Toro, MD Director STD LAB PRPHL DOH

  2. Introduction • This presentation summarizes the experience of the newly appointed Director for the Puerto Rico Health Department Sexually Transmitted Diseases Lab, in transforming the institutional culture in order to comply with CDC program objectives successfully. • The information is updated to the third trimester of 2006

  3. That was then… • July 2005 • Facts: • LIS for Lab services were poorly understood • LIS project meetings repetitive • Installation progress slow • NO LIGHT AT END OF TUNNEL!!!

  4. That was then… • July 2005 • The laboratory was submerged in a never ending story of: • Sample accumulation • Manual processes not finished • Discrepancies not solved • TAT not acceptable • There was a lack of interest and frustration among employees to give the LIS an opportunity to be used and improved as necessary

  5. That was then… • TAT for VDRL June 2005 …a 5% sample of all VDRL samples reported were evaluated for TAT (150 samples)…

  6. That was then… • The numbers did not look GOOD!!!!! • Something needed to be done, RIGHT AWAY!!!! • The transformation began: • The changes needed to be small, fast, frequent and cheap!

  7. This is now! • 1. Change the way of thinking of the personnel by: • Establishing clear goals • Organization and discipline • Participation • Set the example • 2. Insertion in the change process • 3. Become a process facilitator • 4. Communicate effectively and frequently • 5. WORK VERY HARD!!!

  8. This is now! • Soon enough things started to change: • The LIS meetings gave way to an improvement in DATA ENTRY time: • From 5 min to 1.47 min per order • This new entry time gave way for data entry personnel to feel more productive. • Happier people are more productive people!

  9. This is now! • The next step was to provide a better work place for the data entry people. • An area was identified outside the Lab • The area was remodeled • Provided with LIS access • Individual stations were re-used • Bigger, better, quieter and FREE!!!!!!!!!! (nothing can be cheaper)

  10. This is now! • Data Entry Coordinator appointed • A Schedule for Test Order Entry was designed in a 1.5 hrs shifts. • Data entry improved, lab procedures improved, sample analysis improved and results reporting improved!!!

  11. …that was then, this is NOW! TAT VDRL June 2005 TAT VDRL Oct 2006

  12. …that was then, this is NOW! TAT Chlamydia Oct 2005 TAT Chlamydia Oct 2006

  13. This is now • More changes: • Better QA procedures and analysis • Redesign of QA committee • Integration of DATA ENTRY supervisor • Daily log for discrepancies developed • QA processes will be discussed monthly • Centralization of sample processing • Reassign duties • New testing priorities established: • The lab strictly follows Surveillance Programs compliance priorities • The programs set necessities, LAB provides services • Communication between LAB and Programs is strongly supported and encouraged

  14. This is now! • TEAMWORK Really works!

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