Pap Testing in Ireland & Massachusetts

IT IS PURELY COINCIDENTAL that, in this issue, you will read intelligence briefings about Pap testing in Ireland (see pages 3-5) and Massachusetts (see pages 10-15). Yet, both stories, taken together, send an important message to laboratory executives and pathologists.

Because of ongoing evolution in healthcare, laboratories must continuously innovate and improve specifically to maintain their value proposition with referring physicians and payers. Ongoing change is rapidly becoming the prime directive for clinical laboratories and pathology groups. This dynamic is illustrated differently in the stories about Pap testing in Ireland and Massachusetts.

In Ireland, last year health authorities outsourced all the nation’s Pap testing to a laboratory in the United States. This situation came about because Irish laboratories—for a variety of reasons—had allowed turnaround time for Pap test results to stretch out to six months, and sometimes even longer. Independent of other considerations, this created the opportunity for Irish health officials to fix this problem in a radical manner. Their solution was to outsource all the country’s Pap tests to a laboratory in the United States that committed to meet a 10-day turnaround time.

I submit that, had Irish laboratories enthusiastically embraced quality management techniques—such as Lean, Six Sigma, and rapid process improvement—in recent years, they would have made great strides in slashing Pap test turnaround time. Using a proactive focus on meeting and exceeding customer expectations, Irish labs would likely have dramatically cut lengthy reporting times for Pap tests. In turn, this would have eliminated TAT as a justification by health system authorities to outsource all Irish Pap testing to an overseas lab.

By contrast, our Massachusetts Pap test story is the opposite of the Irish lab experience. At Baystate Medical Center in Springfield, the lab team, on its own initiative, introduced Lean methods. A first project was to reduce average turn- around time for Pap tests—specifically to better compete for outreach specimens. In a 60-day Lean project, it reduced average Pap test turnaround times by 50%.

These two laboratory management case studies make the point. In today’s fast-changing world, every laboratory should think, act, and execute in a forward-looking, proactive fashion. It is smart management to protect and enhance the value proposition the laboratory delivers to physicians, patients, and payers.


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