Long lines of bags used to snake from the closed counters all the way around the waiting area. Each reserved a spot in the queue for a person waiting for the blood collection service to open. With waiting times of more than two hours, it wasn’t uncommon that patients’ tempers flared. Staff felt harried, which led to poorer performance.

This was the scene that used to greet us every morning at Maharaj Nakorn Chiang Mai Hospital, a leading tertiary care hospital in northern Thailand. In 2015, however, we decided to transform our service into a patient-centred operation that offered better value to both patients and the hospital.

To deliver this transformation, the laboratory medicine team identified three key areas that needed improvement: our queueing system for blood collection, our laboratory IT systems and our operational policies.

Building a novel blood collection queue system

One major step in our transformation was to move from a paper-based queueing system to a digital queue. Upon arrival at the hospital, patients can now scan their particulars at a kiosk that immediately informs them if they have come on the right day. The kiosk is linked to the hospital information system and allocates queue numbers based on patients’ medical records and needs.

Alternatively, patients can register by downloading the hospital’s app on Line, a popular social media service in Thailand. They will then receive alerts as they advance in the queue. 

These transformations cut overall waiting time from three hours to no more than one hour. They also streamlined the number of steps in the blood collection process.

This improvement alone has dramatically boosted patient satisfaction rates, which have risen to 83% from 75%. Staff are also happier with this system, with satisfaction rates hitting 80%, up from 71%.

Harnessing technology for lean management

A second change involved harnessing technology in the laboratory in order to reduce errors and eliminate waste. To do so, we leveraged our automatic blood collection system, which ensures that the right samples are drawn from the right patient.

Since our blood collection system is connected with the laboratory information system, it allows us monitor queue status and blood draws from the lab, tracking every sample at every step of the way. By analysing these data through the lens of lean management processes, we were able to improve the total lab turn–around time.

Restructuring our operations with the patient in mind

To build a better experience for patients, we also decided to change several of our operational policies. For example, after noticing that demand for blood drawing services peaked between 6.30-8.30am, we decided to change our operating hours to start at 6.30am instead of 7am.

We also increased the number of staff on duty during the early hours to prevent long lines from forming, and changed the payment structure for medical technicians who work at the hospital on a part-time basis. Instead of an hourly rate, we moved to pay them for each successful blood draw, thus incentivising staff to be more productive with their time.

After implementing these adjustments, more than 90% of patients now spend less than 30 minutes waiting to have their blood drawn. In terms of satisfaction, patient satisfaction rose to 93.8% in the period from 2016-2018, up from 81% in the period from 2014-2015. This was a major improvement.