Diagnostic Imaging Project

Fred Koeman – Lean 6 Sigma Black Belt – Project Management Professional

The Challenge:

Patients are experiencing longer than expected wait times for diagnostic imaging resulting in extreme dissatisfaction with the level of service.

The Goals:

• Reduce lead times from referral to result while Improving patient and staff satisfaction.

• Better understand the delays impacting tests and procedures for inpatients and identify opportunities to improve turnaround times for inpatients for more timely clinical decisions and to expedite discharges.

• Implement leader standard work, visual management, and huddle boards.

The Approach:

A 2-day value stream mapping event was conducted with key stakeholders to map every step in key processes process from start to finish. The value stream identified process wastes and analyzed the flow of staff, patients, information, communication, materials, supplies, medications, etc. within a process. The team then brainstormed opportunities to improve the flow of the process to increase value and satisfaction for patients and staff. The main issues that were identified:

• Absence of e-referral strategy and integrated workflow (referral, triaging, scheduling and communication) between Meditech and PACS

• Lack of patient-centric after-hours arrival and registration process

• Referral and scheduling backlog

• Excessive administrative duties for technologists

• Wayfinding (locating DI, appropriate waiting room and next steps)

• Multiple competing methods of registration and challenges with communication

• Lack of understanding by some staff on how to properly use the Connexxal transport system.

• Poor communication between units and DI when a patient is cancelled or needs to be rescheduled.

• Patients not prepped and/or ready when porters arrive on units.

Next Steps:

• Cross-functional sub-teams have been formed to problem solve and implement sustainable changes to improve the patient and staff experience.

• A3 problem solving templates have been created for each sub-team describing the current issues and gap analysis.

• A draft project accountability framework has been created to keep projects on track and to address risks and barriers.

Expected Results:

• Implementation of end-to-end electronic e-referral strategy (2024).

• Standardized patient-centric entrance and registration process.

• Reduced booking backlog to 1 day of referral inventory.

• Reassigned administrative duties from technologist to free up scanning resources.

• Improved wayfinding for patients and families.

• Enhanced training on the proper use of the Connexxal transport system to improve communication and eliminate cancelled/rescheduled inpatient diagnostics.

• Improved patient prep process to eliminate delays/cancellations of diagnostics.

• Development and Implementation of standardized daily huddle board questions

• Leader Standard Work (LSW) training for all DI Managers

• Finalize LSW Plan-Do-Study-Act (PDSA) – which has been initiated to test and finalize prior to spreading to other areas.

• A review of visual management tools and techniques with recommendations for implementation