Project Title

Urine Chemistry Bench Workflow Change to Improve Turnaround Time and Prevent Repetitive Injuries as a Unit Based Team Project

Graduation Date


Document Type

Culminating Project

Degree Name

Master of Science


Clinical Laboratory Sciences

Program Director

Mary Sevigny, PhD

Faculty Advisor

Howard Koo, MS, CLS

Project Supervisor

Keith Ng


In 2018, workflow issues due to workload increase in the urine chemistry bench and short staffing due to unscheduled absences caused turnaround delays of the reflexed Urine Protein Creatinine ratio and an increase in repetitive injuries. A Unit-Based Team project was proposed to address the turnaround time delays and repetitive injuries. The SMART (Specific, Measurable, Achievable, Relevant and Timebound) goal was to improve performance, workflow efficiency, and prevent repetitive injuries from January to April 2019. This project aligned with the region’s business strategy using the four points of the Value Compass on quality, affordability, service, and the best place to work. The Pareto analysis was used to focus attention on critical findings. A comprehensive root cause analysis was then performed to determine the underlying causes. After several brainstorming and interest-based problem-solving huddles, a fishbone diagram was formed to help identify the potential root cause. By using the 5 Whys, the root cause was defined as not including the Urine Microalbumin testing in the day shift task rotation. Creating steps of change became part of the corrective and preventive action plan. The established measures of effectiveness for the next six months were meeting 99 % of the turnaround time goal of the reflexed Urine Protein Creatinine, there should be no reported incidents of repetitive injury and no unscheduled absences due to repetitive injury. Turnaround time continued to improve despite setbacks and challenges. There are no new reported incidents of repetitive injury. Better teamwork on both shifts has developed from this project and helped boost staff morale. Effective practices that were implemented lead to positive results. The steps of change use the Deming’s cycle of plan, do, check, act for Continuous Process Improvement. If the project did not meet the goal by using the “Small Test of Change” process, then it can be extended to achieve a satisfactory result.

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