Faster Medical Imaging in Five Days

North Shore University Hospital wanted to improve patient throughput on its CT scanners to decrease LOS and increase patient satisfaction. Average turnaround time (TAT) was 20.7 hours and varied from 8 to 34 hours. The target for improvement? 16 hours. Identified problem areas included

• Manual scheduling process leading to calls from nursing units
• Time-consuming prep and delivery of contrast medium
• CT tech travel to requisition printer (6,480 feet per day)
• Transporter availability and travel (432 feet per day)

After analysis of these various issues, the improvement team implemented several countermeasures:

• The requisition printer was relocated in between the two CT scanners, saving over 6,000 feet per day of unnecessary travel.
• Dedicated CT transporter was assigned.
• An Excel-based schedule was maintained in imaging and was viewable by all nursing units (this reduced phone calls and cancellations owing to improper patient prep or availability).
• Instead of a rigid schedule with no room for STAT orders, a “pull” system adjusted the patient transport and scan to accommodate just-in-time STAT scans.
• Contrast preparation was reassigned to the evening shift, refrigerated, and delivered during the transporter’s morning run for inpatients.
• One CT scanner was dedicated to complex procedures, and the second was dedicated to routine high-volume procedures to maximize patient flow.
• Staffing was adjusted to demand.

Results

• Average TAT fell from 20.7 to 6.45 hours.
• 200 additional inpatient scans were done per month.
• 60 additional outpatient scans were done per month.
• This resulted in $375,000 in additional revenue.
• Cancellations owing to improper prep dropped from 30.6 to 22.7 percent.

At Newton-Wellesley Hospital, radiology turnaround stood at 45 minutes. After examining patient and technician flow, the hospital found that technicians spent too much time walking around. By redesigning the work flow, turnaround times fell to 25 minutes, making the planned addition of another $500,000 x-ray machine unnecessary.

Massachusetts General Hospital’s proton beam facility was fully booked, or at least so the hospital thought—until it did a little analysis. By batching patients requiring anesthesia on the same day and scheduling an anesthesiologist for that day, throughput increased from 29 patients per day to 39 patients—a 33 percent increase.