In 2014, Baptist Collierville leaders began examining the high rate of contamination occurring during blood draws. Many factors can lead to a contaminated specimen, including improper use of gloves, failure to sanitize the patient’s skin correctly or inadequate training. The associated costs can be a burden.
“Each sample costs approximately $208. Running multiple blood tests due to contamination not only drives the cost up, more importantly, if we have to redraw blood, we are causing the patient unneeded discomfort,” said Kyle Armstrong, administrator and CEO of Baptist Collierville.
As the Baptist Collierville team analyzed the situation, the primary stumbling block to greater efficiency appeared to be the lack of training for team members. With that in mind, leaders developed very specific goals using Training Within Industry (TWI), a process that turns standard work into standard behavior. Identifying Important Steps, Key Points and the Reasons behind a process help define meaning and quality.
“For instance, we have one nurse with more than 20 years of experience who followed the correct procedure, but never really knew why she was putting a patient’s blood sample in a blue container first, then a purple one. By teaching her the reason, now she understands the process better,” said Armstrong.
TWI involves memorization and application. Team members repeat their knowledge several times until trainers are confident the information has been consumed correctly. Front-line staff is directly involved in determining the job breakdown, or list of important steps.
TWI helped Baptist Collierville significantly reduce the number of repeat blood draws team members had to perform.
“Our past costs ran about $2,900 per month for blood drawings. After implementing TWI, we hit $900 one month,” said Armstrong.
Baptist Collierville has employed TWI techniques to break down 40 to 50 jobs, including those surrounding admissions, labs, nursing and surgery. The results are tangible. Moving forward, the key to maintaining success involves continued training and monitoring.
“TWI isn’t for every job, so we have to decide what makes sense. It seems to make most sense for technical training,” said Armstrong.