1. Internship Abstract
Title: University Hospital Operating Procedure Analysis & Process Improvement
Name: Samuel Chen
Preceptor: Direct Supervisor: Achalanka Dalawella, Lean Project Manager/Black Belt
Agency: Robert Wood Johnson University Hospital, Lean Department
Purpose:​ To analyze and improve the current hospital operating procedure of stress testing at the
Robert Wood Johnson’s Somerset Campus to decrease the overall turnaround time (TAT) from the
initial request for the test till completion.
Significance:​ Robert Wood Johnson University Hospital recently acquired Somerset Medical Center
and is currently undergoing many changes to align the two hospitals so that maximum productivity is
achieved. My project specifically looks at stress testing turnaround times. Currently, TAT for
inpatients is round 18.7 hours while TAT for observation patients is 15.1 hours. Being able to reduce
that time to the industry baseline of approximately 4 hours will garner a financial impact that could
significantly improve other services, client relations, and overall generate a more desirable ­ higher
quality hospital for patients.
Method/Approach: ​Lean is a valuable and indispensable tool that departments can utilize to help
them reach their departmental goals. The first step is scoping, followed by data analysis which will
allow us to hone in on where to focus. Following Six Sigma’s DMAIC (define measure, analyze,
improve, control) process we will hopefully be able to improve the overall business process. Through
scoping, fishbones and data we received ­ we found that the current turnaround time for a singular
stress test was around 19 hours. The baseline and generally accepted number is around 4 hours. We
then delve into what the bottleneck and root cause of the extended TAT was.
Outcomes: ​Thus far, the discovery that a singular stress test requires multiple personnel of different
specializations seems to be the speed bump. Coordination of several people is require to ensure a
smooth and rapid test. However, some of the MD’s are community physicians and cannot be present
at all times ­ thus leading to delays. In addition thallium has to be ordered and has a rapid expiration
date, so it needs to be added to the equation. With all the pieces we found that at maximum, the
department should process 3 patients before noon, given a 7am start time.
Evaluation: ​The current workflow and appointment structure is being implemented for testing and to
see if the changes to scheduling will be able to sustain the volume and turnaround time for Nuclear
Stress Testing.