Summary

A discussion of the LIS Project is important in conveying how the project was organised and operated. There are a number of questions being asked such as – how was the team selected? How was a particular matter decided?  These are valid and appropriate questions and so it is hoped that a discussing of the project will, to an extent, address some of the queries.

Philosophy

The Campus determined that the Departments will rely primarily on its own staff for implementation of the LIS system in order that knowledge remains within the lab operations, and that staff obtain the benefit of the exposure. In general this is an approach which is willing to sacrifice speed for the benefit of the long term gain.

Failures and Accomplishments

Some of the notable successes have been

• Software built, able to function across all labs
• Hardware fully implemented (IBM server, terminal servers, backup server…)
• Attractive Financing arrangement made with SCC - agreed and executed
• Entire build team has been trained
• All lab equipment have been interfaced into the LIS to facilitate direct data transfer (Note: there are a few which are not functioning consistently due in to age or mapping issues) 
• Establishing of the environments for the LIS implementation build process (build rooms, connectivity, secure electronic communication with SCC…etc)
• Effective and on-going collaboration with the UHWI on  training and IT infrastructure requirements
• Establishment of the TCAA
• Training of the main Super User team has been completed
• Awareness building programme established to include all groups of stakeholders (UHWI, Departmental staff, Consultants, residents, associated entities such as the Health Centre. This will continue until the project is in live operation.
• Documentation – user manuals and training manuals have been customized for the UWI environment. This is over 80% completion overall, changes are expected as the validation proceeds (April 14). 

The two major failures of the project have been

1. Ability to meet stated timelines
2. Ability to contain the budget within the agreed overall limit

The factors that have contributed to these failures are

1. Significant requirements for infrastructure spending which had not been foreseen as ‘project’ costs. These include renovation and equipping of space for central accessioning, network upgrade to rooms and buildings….etc. These have been identified and are to be put forward for decision regarding appropriate allocation. 
2. Deadlines are conditional on resources. The project has struggled with the purchasing of resources due largely to the flow of funding. Timing has consequences. 
3. The sharing of people resource in multiple-roles (i.e. other departmental imperatives) have also had an effect, but less significant than the two above.

Project Approach 

Standard Project Management techniques were applied, tweaked to suit the UWI environment (particularly Microbiology and Pathology) but still focused towards delivering the project within guidelines. As such it is decomposed into the following project phases:

• Initiating
• Planning
• Executing
• Monitoring & Control
• Closing

Steering committee 

The role of the Steering Committee includes budgetary oversight; decision making regarding scope changes; high level decision making regarding boundaries, restrictions, policies; resource approval; high-level decision making.

The Committee Comprises

1. Chairman (someone with significant authority from FMS)
2. Dean FMS
3. HOD Pathology
4. HOD Microbiology
5. HR Representative (Senior level)
6. Bursar
7. MITS representative (Applications Manager)
8. UHWI representative (CIO)
9. Project Management team

Project Teams

 Work is organised in teams representing each lab and Campus IT. Each team is led by a team leader. The teams are:

        i.      Chemical Pathology team;

        ii.     Haematology team;

        iii.    Virology team; 

        iv.    Immunology team;                      

        v.     Microbiology team

        vi.    Anatomical Pathology – Cytology team

        vii.   Anatomical Pathology – Histology team

        Viii.  Blood Bank

        ix.    LIS Administration team

        x.     Technology Team (i.e. MITS)

        xi.    Project Management Team

Requisition Form

Our responsibility to clients (such as UHWI, external clinics and doctors) and to patients demand that we offer a service that enhances routine operations and reduces patient stress. To this end it was imperative that within the LIS project we address the issue of the preparation of requisition forms for ordering of tests.

The Existing System for Requisitioning Diagnostic Tests is as follows:

• Currently each laboratory uses at least one individual requisition form
• Some laboratories use multiple requisition forms for different diagnostic tests
• An estimated 20 different requisition forms are currently in use by all the laboratories in Microbiology and Pathology
• Requisition forms serve a dual functionality: requisitioning of laboratory tests and reporting of test results
• Physicians requisitioning tests are frequently required to prepare multiple requisition forms for diagnostic tests for patients attending one or more laboratories, which constitutes ineffective use of physicians’ time
• Patients are frequently required to traverse multiple laboratories to present  requisition forms, which is a primary source of inconvenience and patient dissatisfaction
• Requisition forms are manually prepared and presented to the laboratories

The New System for Requisitioning Diagnostic Laboratory Tests

Will result in integration to the extent of: (1) a main requisition form which will provide for requisitioning of tests for the Microbiology laboratories, Blood Bank, Chem Path, & Haematology; (2) a Blood Bank supplemental requisition form, which will serve as a Blood Bank original; (3) a requisition form for Cytogenetics, Cytology, Flow Cytometry, & Histology

Download Requisition form