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Focused Process Improvement Events: Sustainability of Impact on Process and Performance in an Academic Radiology Department

Rosenkrantz, Andrew B; Lawson, Kirk; Ally, Rosina; Chen, David; Donno, Frank; Rittberg, Steven; Rodriguez, Joan; Recht, Michael P
PURPOSE: To evaluate sustainability of impact of rapid, focused process improvement (PI) events on process and performance within an academic radiology department. METHODS: Our department conducted PI during 2011 and 2012 in CT, MRI, ultrasound, breast imaging, and research billing. PI entailed participation by all stakeholders, facilitation by the department chair, collection of baseline data, meetings during several weeks, definition of performance metrics, creation of an improvement plan, and prompt implementation. We explore common themes among PI events regarding initial impact and durability of changes. We also assess performance in each area pre-PI, immediately post-PI, and at the time of the current study. RESULTS: All PI events achieved an immediate improvement in performance metrics, often entailing both examination volumes and on-time performance. IT-based solutions, process standardization, and redefinition of staff responsibilities were often central in these changes, and participants consistently expressed improved internal leadership and problem-solving ability. Major environmental changes commonly occurred after PI, including a natural disaster with equipment loss, a change in location or services offered, and new enterprise-wide electronic medical record system incorporating new billing and radiology informatics systems, requiring flexibility in the PI implementation plan. Only one PI team conducted regular post-PI follow-up meetings. Sustained improvement was frequently, but not universally, observed: in the long-term following initial PI, measures of examination volume showed continued progressive improvements, whereas measures of operational efficiency remained stable or occasionally declined. CONCLUSIONS: Focused PI is generally effective in achieving performance improvement, although a changing environment influences the sustainability of impact. Thus, continued process evaluation and ongoing workflow modifications are warranted.
PMID: 25444063
ISSN: 1546-1440
CID: 1370242

Impacting Key Performance Indicators in an Academic MR Imaging Department Through Process Improvement

Recht, Michael; Macari, Michael; Lawson, Kirk; Mulholland, Tom; Chen, David; Kim, Danny; Babb, James
PURPOSE: The aim of this study was to evaluate all aspects of workflow in a large academic MRI department to determine whether process improvement (PI) efforts could improve key performance indicators (KPIs). METHODS: KPI metrics in the investigators' MR imaging department include daily inpatient backlogs, on-time performance for outpatient examinations, examination volumes, appointment backlogs for pediatric anesthesia cases, and scan duration relative to time allotted for an examination. Over a 3-week period in April 2011, key members of the MR imaging department (including technologists, nurses, schedulers, physicians, and administrators) tracked all aspects of patient flow through the department, from scheduling to examination interpretation. Data were analyzed by the group to determine where PI could improve KPIs. Changes to MRI workflow were subsequently implemented, and KPIs were compared before (January 1, 2011, to April 30, 2011) and after (August 1, 2011, to December 31, 2011) using Mann-Whitney and Fisher's exact tests. RESULTS: The data analysis done during this PI led to multiple changes in the daily workflow of the MR department. In addition, a new sense of teamwork and empowerment was established within the MR staff. All of the measured KPIs showed statistically significant changes after the reengineering project. CONCLUSIONS: Intradepartmental PI efforts can significantly affect KPI metrics within an MR imaging department, making the process more patient centered. In addition, the process allowed significant growth without the need for additional equipment or personnel.
PMID: 23245434
ISSN: 1546-1440
CID: 214422

Best in practice: a model for improved radiologist-technologist collaboration and image optimization

Recht, Michael; Kim, Danny; Lawson, Kirk; Mulholland, Thomas
PMID: 21458769
ISSN: 1558-349x
CID: 130257