Process Improvement in Phlebotomy

This study has two main objectives. First, the phlebotomy process at the St. Catharines Site of the Niagara Health System is investigated, which starts when an order for a blood test is placed, and ends when the specimen arrives at the lab. The performance measurement is the flow time of the process, which reflects concerns and interests of both the hospital and the patients. Three popular operational methodologies are applied to reduce the flow time and improve the process: DMAIC from Six Sigma, lean principles and simulation modeling. Potential suggestions are provided for the St. Catharines Site, which could result in an average of seven minutes reduction in the flow time. The second objective addresses the fact that these three methodologies have not been combined before in a process improvement effort. A structured framework combining them is developed to benefit future study of phlebotomy and other hospital processes.

Elaborative interrogation as a learning technique for students with learning disabilities

This study examined whether or not students with learning disabilities could effectively use a question and answer strategy known as elaborative interrogation. This technique involved students answering why they thought facts based on familiar animal stories were true. Thirty students from a provincial demonstration high school (for students with learning disabilities) were assigned to one of two study conditions, (a) elaborative interrogation or (b) reading for understanding. Three students, one from the experimental condition and two from the control did not complete the study. Both conditions required that the students learn 36 facts concerning six familiar animals. Immediately following the study session the students completed a free-recall test, a matched association test and a questionnaire regarding their perceived difficulty of the animal stories. After 30 days a matched association test was completed. The oneway ANOVA, 2 x 2 split plot ANOVA and Tukey's Honestly Significant Test were used to determine significance. There was no significant difference in the two conditions for free recall retention. There were significant differences in the elaborative interrogation condition for the immediate matched association test and for the 30-day matched association test. The probability of the students' responses in the elaborative interrogation were measured to determine the effects of adequate responses on long-term retention. It was found that the adequate responses were more likely to promote retention than inadequate responses. In conclusion, long-term retention of factual information was significantly better in the elaborative interrogation condition in comparison to the reading for understanding control. For future research, the dependent measure, free recall should be given both verbally and in written format. In addition, extra time should be allowed for processing of the new information to occur.