IT IS PURELY COINCIDENTAL that, in this issue, you will read intelligence briefings about Pap testing in Ireland (see pages 3-5) and Massachusetts (see pages 10-15). Yet, both stories, taken together, send an important message to laboratory executives and pathologists.

Because of ongoing evolution in healthcare, laboratories must continuously innovate and improve specifically tomaintain their value propositionwith referring physicians and payers. Ongoing change is rapidly becoming the prime directive for clinical laboratories and pathology groups. This dynamic is illustrated differently in the stories about Pap testing in Ireland and Massachusetts.

In Ireland, last year health authorities outsourced all the nation's Pap testing to a laboratory in the United States. This situation came about because Irish laboratories-for a variety of reasons-had allowed turnaround time for Pap test results to stretch out to six months, and sometimes even longer. Independent of other considerations, this created the opportunity for Irish health officials to fix this problem in a radical manner. Their solution was to outsource all the country's Pap tests to a laboratory in the United States that committed to meet a 10-day turnaround time.

I submit that, had Irish laboratories enthusiastically embraced quality management techniques-such as Lean, Six Sigma, and rapid process improvement- in recent years, they would have made great strides in slashing Pap test turnaround time. Using a proactive focus on meeting and exceeding customer expectations, Irish labs would likely have dramatically cut lengthy reporting times for Pap tests. In turn, this would have eliminated TAT as a justification by health system authorities to outsource all Irish Pap testing to an overseas lab.

By contrast, our Massachusetts Pap test story is the opposite of the Irish lab experience. At Baystate Medical Center in Springfield, the lab team, on its own initiative, introduced Lean methods. A first project was to reduce average turnaround time for Pap tests-specifically to better compete for outreach specimens. In a 60-day Lean project, it reduced average Pap test turnaround times by 50%.

These two laboratory management case studies make the point. In today's fast-changing world, every laboratory should think, act, and execute in a forward- looking, proactive fashion. It is smart management to protect and enhance the value proposition the laboratory delivers to physicians, patients, and payers.

Bostwick Builds New Lab Around 25 Ex-AFIP Paths

Bostwick Labs' new pathology business unit intends to offer subspecialty services nationally

CEO SUMMARY: In an opportunistic business move, Bostwick Laboratories is recruiting up to 25 pathologists and a similar number of staff members from the Armed Forces Institute of Pathology (AFIP). AFIP is scheduled to close in 2011, at which time it will transition to the new Department of Defense Joint Pathology Center (JPC). Bostwick is calling its new business "American International Pathology Laboratories," (AIPL). It will operate from a new laboratory facility located in Silver Spring, Maryland.

Lab Market Update: New Lab Company Is Launched By Geisinger Health System

"Proven Diagnostics" is the name of the new firm Geisinger created to tap the lab outreach market

Irish Labs Appeal to Keep Pap Smear Expertise

Decision to outsource nation's Pap tests overseas makes it tough to train new doctors in cytology

CEO SUMMARY: In Ireland, pathologists are asking the government to return enough Pap tests back to the country to support and sustain medical training programs in gynecologic cytology. It was 2008 when the Irish government outsourced all Pap testing to a U.S. lab company. That forced Ireland's major cytology laboratories to shut down their cervical cancer testing, leaving them without access to the specimens needed to support medical training programs in cervical cancer screening and diagnosis.

Using Lean to Cut Pap Test TAT Pays Off At Baystate Medical

Lean ABN Fix Is Another $1 Million Home Run

CEO SUMMARY: It took only one 60-day Lean project for the laboratory at Baystate Medical Center to slash the average turnaround time for Pap tests by 50%, thereby improving its competitive position in the outreach market. Almost simultaneously, another 60-day Lean project attacked sources of write off from missing Advance Beneficiary Notices (ABNs) and incomplete insurance information and produced an additional $1 million in collected net revenue! Both examples of Lean successes demonstrate how innovative clinical laboratories are raising the competitive bar.

Third Laboratory Earns ISO 15189 Accreditation

Empowered lab staff, continuous improvement are two benefits for Blanchard Valley Hospital lab

CEO SUMMARY: In June, the laboratory at Blanchard Valley Hospital became third in the nation to be accredited to ISO 15189:2007. The 150-bed acute facility in Findlay, Ohio, is the only hospital laboratory of its size to achieve accreditation to the ISO 15189 standard. Implementing these standards directly benefited the lab by lifting what was already a top-performing organization to a higher level of achievement. The ISO standards also support an effective culture of continuous improvement that challenges the lab to repeatedly raise the bar.

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