Efficiency Project

Standardization of workflow has shown huge benefit in non-healthcare industries in reducing waste and in introducing predictability for planning purposes. In medicine, the historical challenge has been how to standardize without losing sight of the complexity of patients’ co-morbidities and social environment. In this study, Radiology MRI exams were analyzed to identify unwanted variability. We identified multiple protocols that would benefit from standardization. After changes were introduced, the image capture time was reduced, and variability decreased.

In this project, the client was experiencing MRI exams that ran longer than the allocated slot length which led to long wait times, patient dissatisfaction, and harried staff. Patient satisfaction was a key part of the clients’ mission and from an ROI perspective, it was noticed that patient leakage (patients having their scans performed at a competitor) was increasing.

A simple metric, the duration of the exam from scan start to the scan end, was adopted as a starting point for investigation. The durations of the exams were found to be highly variable for specific protocols but more importantly were found to routinely exceed the allocated slot length.

In designing a response to these insights, it was important to adopt a strategy that could show initial positive impact and also fit the culture of the client. One solution was to try to standardize protocols, enforce no “add-ons”, and to better train staff to ensure no repeated scans. A second approach recognized that the protocols routinely exceeded the allocated slot length, thus slot length was increased to better match the protocol time. This practice led to more predictable times and fewer late examinations.

Improved standardization is a key element of increasing efficiency. Choosing the correct metric, automating the measurement of the metric, and finding the right intervention for the institutional culture are key components in an improvement plan.

Snowstone can assist with designing, implementing, and deploying the right metrics and improvements for your institution.