19 December 2016

Identify Pain Points First to Effectively Implement Radiology Process Improvements

Radiology departments are under tremendous pressure to increase efficiency without sacrificing quality, as nearly every department in the hospital depends on them to produce and read images in a timely manner. Hospital workflows are complex, and investments in new software, equipment or people that are not informed by a thorough understanding of the underlying causes of inefficiencies are unlikely to deliver the desired improvements.

An article in Radiology Today earlier this year advised department heads to do a full assessment of workflow processes to identify the “pain points” that result in inefficiencies. Pain points can be areas that may need improvement, like patient throughput, or areas where variability is introduced to the workflow. Dr. Paul Chang, vice chairman of Radiology at the University of Chicago School of Medicine, said software can often eliminate variability, particularly in workflow management. In situations that require judgment of complex results, it is best to identify strategies to facilitate the radiologists’ reading and decision-making. Solutions introduced into a workflow should address a specific existing problem, particularly given the high cost of investments in new software, equipment or staff.

In radiology, pain points are often procedural, rather than technical. Inefficient protocols that impede patient flow like ineffective patient transport or MRI triage processes can hugely impact the entire hospital by slowing radiology. An American College of Radiology case study detailed the effort to improve MRI patient throughput at Howard County General Hospital in Columbia, Maryland. Patricia Rabette, the hospital’s CT/MRI Manager, led an MRI quality improvement project that aligned everyone involved in imaging processes to eliminate pain points. Rabette scheduled regular meetings with a team including medical-surgical nurses and managers, patient care technologists, the unit secretary, the med-surg directors, MRI technologists, and a transport dispatcher to discuss inefficiencies and solutions. By unifying all the stakeholders into a single team to collaborate on solving the problems and emphasizing open-minded consideration of all ideas, the hospital was able to decrease MRI throughput times by three hours and increase patient satisfaction by 60 percent.

Using cross-functional teams to solve problems collaboratively is also at the center of Sheridan’s approach to continuous process improvement. For example, at one South Florida radiology department, a Sheridan Kaizen facilitator helped a team that included the registration desk, lab, physicians and nurses to closely examine and improve the department’s workflow. Based on the team’s recommendations, a change was made so that instead of requiring outpatients to wait in bed alone for one to two hours while lab results were pending, patients could remain in the waiting room while they awaited their lab results. This simple change decreased radiology wait times by 40 minutes.

Jupiter Medical Center’s Chief of Radiology Dr. Lee Fox, and CEO John Couris discuss how the Sheridan partnership and Kaizen-facilitated process improvements have been transforming radiology at the hospital.