Using LIM to help respond to pandemic

Using Leeds Improvement Method to respond to the pandemic

Mike Philpott, General Manager - Pathology, and Helen Gilbert, KPO Lead, explain how the Leeds Improvement Method has supported the Trust’s response to the Coronavirus pandemic.

The Leeds Improvement Method (LIM) is an improvement programme which aims to improve the efficiency and flow of LTHT services, with patient and staff experience embedded at the centre of this work.

Many teams have continued to use the methodology and skills they have learnt to drive forward improvements during the Covid-19 pandemic.

Improving Covid-19 sample turnaround times

“Work carried out collaboratively in Pathology, Emergency & Specialty Medicine, Abdominal Medicine and Surgery and Facilities using the LIM has significantly improved turnaround times for testing Covid-19 samples. “Data at the beginning of April showed that 90% of samples were being turned around by the pathology team within 24 hours. However, when the time from sample taken was included, that figure fell to just 65%. “The LIM work investigated where the significant waiting times were for the samples and worked to remove these to improve the process. Samples were identified as waiting in the areas and departments where they were taken in some cases for over 90 minutes. Clinical teams worked hard to identify staff to move the swabs onto their local pathology department immediately after they have been taken. “When this was audited after the improvement work, the sampling was shown to take an average of 10 minutes to leave these departments for the pathology lab. “The Transport team significantly increased the number of times they collected from the St James’s Hospital Pathology Lab to every 30 minutes for a run to the Old Medical School at Leeds General Infirmary (where all Covid-19 Swab samples are analysed). This means that the maximum wait time for a sample on the St James’s site has been reduced from over 90 minutes to a maximum of 30 minutes.

“Samples taken in A&E at the LGI during the follow-up audit took an average of four minutes to turn around instead of over an hour and a half at the start of the improvement work. This is because a new system for a member of non-clinical staff to walk samples immediately to the pathology lab was introduced. “Overall, turnaround times are currently averaging at 24 hours - 98% and 18 hours - 93% from collection from the patient to results authorisation and release.

“Now that the Panther PCR platform is fully operational the 12-hour turnaround times have also been improving and currently stand at around 75%. “The Rapid Process Improvement Workshop (RPIW) process identified delays in the release of positive results as these currently require medical authorisation prior to release. With the additional quality assurance provided by the new Panther machines, the positive results are released directly and therefore contribute further improvements to turnaround times.

“By reducing the turnaround time for these samples, we have been able to improve patient flow around our hospitals by ensuring that we know at the earliest opportunity whether a patient is Covid positive or negative and needs to continue being isolated. “This impressive work shows how the Leeds Improvement Method is really making a difference in our hospitals and across the region, as the laboratory team work to support the region in its PHE capacity for Covid-19 testing. Even when faced with the challenges of a global pandemic, our teams are passionate about driving forward improvements for the benefit of patients and staff.”