From the November 2019 issue of HealthCare Business News magazine
By Daniel Littlefield
A hospital in the southeastern U.S. was facing significant challenges in its radiology department.
Workflows had been designed to accommodate each functional area separately and as a result, wait times for MR exams were 180-plus days, while at the same time, scanner utilization was less than 35 percent. Employee morale was low, patient satisfaction scores were low and the department was bloated with inefficiencies.
Department leaders knew they had to do something different, so they shifted their approach by implementing lean methodology into all facets of their department’s processes.
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Lean thinking requires managing the array of processes within a value stream, not the function itself. A lean organization uses the voice of the customer to drive operational decisions and designs, and to guide the flow of the work in a single direction using the shortest distance. Lean works by integrating the right amount of resources at the right time at the highest quality to provide what the customer needs, the right way, the first time. Using real-time performance measures and visual cues to make succinct, accurate information available, it dramatically reduces or eliminates wait times.
In the case of a radiology department, the value stream includes processes such as registration, performing the test, producing test results, and communicating those results to the ordering physician and the patient. And sometimes these processes are different depending on whether the patient needs an X-ray, CT, MR, or nuclear medicine test. After the department began incorporating lean processes through a rapid improvement event, it reduced its wait time by 70 percent and increased its MR scanner utilization by 60 percent.
Go with the flow
The lean mission is centered on waste elimination — identifying it, naming it and eliminating it — and it can be achieved in part by going with the flow. To improve flow, implement actions that create value without interruption, waiting, barriers or detours. Keys to making products and processes flow are co-location of employees performing similar functions, improvement of product quality, work level-loading and the elimination of batches.
For instance, say a technologist decides to batch process three images, and then put the results of the three patients in front of the radiologist. If the scanner takes eight minutes, and it takes 12 minutes to process each image, the first image will have waited 60 minutes before the radiologist sees it. It seems quicker to process several at one time, and it may be quicker for the employee checking off tasks on a to-do list, but a batched process is only quick for the last product processed. A better flow would be to process one image at a time and give it to the radiologist so the ordering physician receives results more quickly.