1. CROPIA Project - 1 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Project Scope Evaluated (by on-site observations and intervention) the routine day-to-day activities of the medical laboratory Provided recommendations on modifications to the operational processes, procedures, and policies to optimize the workflow, performance, and overall customer (both internal and external) satisfaction with the courier Optimized all courier routes using Arc Logistics® route optimization software to facilitate bringing in work (specimens) earlier in the workday Gained analytical insights into the impact of the optimal solution on the overall system using Enterprise Dynamics® simulation software

2. CROPIA Project - 2 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Observations At initiation of the project, the following conditions existed:  Total courier vehicles: 15  Total FTEs: 15  Total courier routes per day: 10 + local run  Courier routing automation deployed: Hand-written route sheets  High specimen processing costs (overtime) due to unbalanced arrival rate of specimens Number of requisitions processed: 1000–1100 per day Several high volume specimen receipt time frames during AM, PM and Night Shifts  ~11:30 AM, ~2:00-5:00 PM, and ~10:00 PM

3. CROPIA Project - 3 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Observations Non-optimal work load leveling required the use of a midnight shift and overtime Utilization of Medical Technologists (MTs) was not uniform across different shifts due to non-optimal work load leveling Non-uniform utilizations of MTs made it difficult to optimize the shift schedule and avoid overtime Specimen processing staff have limited workstations Approximately 30-45 minutes of courier time is wasted between specimen drop-off and route continuation

4. CROPIA Project - 4 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Observations Lack of visual signaling resulted in the delay in retrieval of specimens from the ballroom area by pre-processing technicians (visual management) Specimen testing procedures were not standardized  For example: Grouping specimens by Tests or by Clients Stability of Gajema Handhelds hampered the courier efficiency

5. CROPIA Project - 5 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Agenda Introduction to PMC Project Scope Observations Process Improvement Methodology Route Optimization Model Simulation Model Results and Recommendations Questions and Discussion

6. CROPIA Project - 6 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Process Improvement Methodology PMC consultants spent 2.5 days on site to map the current value stream Primary areas reviewed included: specimen processing, couriers and technical departments Value Stream Mapping was utilized to illustrate the current process flow graphically This was accomplished with a cross-functional client team

7. CROPIA Project - 7 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Process Improvement Methodology Data collected was brought back to PMC for analysis Captured data entered into Arc Logistics® route optimization application Route Optimization solution for load leveling was finalized after several iterations Data collected from technical departments translated into Enterprise Dynamics® simulation modeling tool to analyze the effects of load leveling

8. CROPIA Project - 8 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Process Improvement Methodology Simulation model output validated by PMC/client team Validated model results confirmed that the night shift can be eliminated if perfect load leveling is achieved New courier routes reviewed and validated by PMC/client team In some cases, adjustments made for specimen pickups Data for optimal courier routes was validated by actual observations

9. CROPIA Project - 9 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Agenda Introduction to PMC Project Scope Observations Process Improvement Methodology Route Optimization Model Simulation Model Results and Recommendations Questions and Discussion

10. CROPIA Project - 10 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Route Optimization Model Screenshot of “Map View”

11. CROPIA Project - 11 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Route Optimization Model Screenshot of “Time View”

12. CROPIA Project - 12 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Agenda Introduction to PMC Project Scope Observations Process Improvement Methodology Route Optimization Model Simulation Model Results and Recommendations Questions and Discussion

13. CROPIA Project - 13 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Simulation Model OBTAIN SPECIMENSPRE-PROCESSING CHEMISTRY LAB HEMATOLOGY LAB MICROBIOLOGY LAB SEROLOGY LAB COURIER TEAM Big Picture SEROLOGISTS MICROBIOLOGISTS HEMATOLOGISTS CHEMISTS

14. CROPIA Project - 14 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Simulation Model SPECIMEN ARRIVES OPERATOR PROCESSES SPECIMEN SPECIMEN DELAYED IN LABORATORY Laboratory OPERATOR MISC. TIME

15. CROPIA Project - 15 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Simulation Model Courier routes are black-boxed (schedules are based on actual trip times) Weekends are not modeled Operator walk times and lunch breaks are not considered In order to prevent blocking, the following is assumed  Infinite buffers between each department  Infinite capacities for laboratory testing equipment

16. CROPIA Project - 16 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Simulation Model

17. CROPIA Project - 17 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Simulation Model Model screenshot (2-dimensional)

18. CROPIA Project - 18 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Simulation Model Model screenshot (3-dimensional)

19. CROPIA Project - 19 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Simulation Model Base scenarioLoad leveling scenario

20. CROPIA Project - 20 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Agenda Introduction to PMC Project Scope Observations Process Improvement Methodology Route Optimization Model Simulation Model Results and Recommendations Questions and Discussion

21. CROPIA Project - 21 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Results and Recommendations Optimization of initial routes revealed that the traditional routes would allow for the re-allocation of 2 couriers Historical data analysis revealed that inflow of specimens based on the traditional routes had multiple spikes and thus required work load leveling The work load leveling achieved, as a result of optimized routes, helped the client to eliminate the night shift and improve the utilization of its morning shift medical technologists using simulation Route optimization and subsequent work load leveling resulted in the reduction of 2 MT FTE resources (approximately $110,000 savings per year)

22. CROPIA Project - 22 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Results and Recommendations It is also recommended that one of the re-allocated couriers be used as a runner who would retrieve specimens along with Gajema handhelds from other couriers returning to the site.  This would result in savings of approximately 30-45 minutes of time which would otherwise be considered non-value- added activity  This would increase the availability of couriers for further improvement in work load leveling To maintain optimum load leveling, courier routes should be re-optimized if there are changes/additions in the number of specimens and/or customer pick-up points

23. CROPIA Project - 23 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Agenda Introduction to PMC Project Scope Observations Process Improvement Methodology Route Optimization Model Simulation Model Results and Recommendations Questions and Discussion

24. CROPIA Project - 24 www.pmcorp.com 2008 IIE ANNUAL CONFERENCE & EXPO forums.pmcorp.com NEW! Questions & Discussion ?