Using radiology informatics for performance improvement
With spending in global healthcare continuing to rise, so too does the pressure on healthcare providers to do more with less.
Declining reimbursements for imaging studies have burdened radiology departments with fewer resources to deliver the quality care patients need, and in the era of value-based care that has led the industry to rethink how best to prove its operational value.
Getting it first time right
From the workload involved in getting patients in and out of the imaging suite, ensuring images are right the first time and managing their administrative duties, it is difficult to overlook the critical role of radiology in a value-based healthcare system. There are many factors involved in getting a first time right patient diagnosis, before, during and after a patient undergoes a scan. Radiology administrators need to be able to identify where in the patient journey improvements can be made to make the diagnosis as quick as possible, and get the highest quality images. And behind all of those factors is quality data which can tell you how your systems are being utilized. “It’s all about giving the right exam at the right time, making sure we get patients in and out of the hospital, get them treated in a coordinated effort,” says Bill Barta, Administrative Director of Imaging Services at Phoenix Children’s Hospital. “The ability to monitor equipment – and have it fully utilized - and manage staffing in real time has major significance on the way healthcare is delivered. The days of putting off an exam or procedure on an inpatient from a Friday to a Monday are gone.”
Challenges in imaging
The pressures on radiology means that each piece of equipment needs to be used to its fullest capacity, to support staff and patients and give radiologists and referring physicians the fastest path to a clinical decision. Phoenix Children’s radiology department handles around 30 to 40 patients in their MRI suites per day – up to 200 per week. Like many radiology departments, the aim is to get their patients in and out of the imaging suite – and the hospital – as efficiently as possible, while ensuring that the right images are processed quickly. The role encompasses much more than that. From the scheduling of the exam through to the patient’s billing, the radiology administrative team is key to the patient care journey, guiding them through experiences that can be daunting; managing complicated workflows; and, seeing to additional reporting tasks and duties. Difficulty obtaining accurate images can lengthen the duration of tests that often require patients to lie in uncomfortable positions or remain sedated/anesthetized for longer periods of time. Delays in report delivery can impact the speed at which a diagnosis is reached and treatment can begin, and there are also added costs associated with rescans.1 “One patient you see is going to be anaesthetized, while another one will be awake,” says Matt Eslinger, Lead Technologist, MRI, Phoenix Children’s Hospital. “One of the hardest things that we have to do is try to figure out how best to schedule and co-ordinate those patients, and how to best operate each room that we have for them, and then how to best allocate our staff to handle their needs.”
To act and improve
Radiology departments routinely collect large volumes of data. Quite often it might not be the right kind of data – it can be unstructured, unreliable or there can be gaps which prevent the technologist from building an accurate picture of how the department is operating in terms of room turnover times, the consistency of protocols and the type of exams being performed. “Radiologists have the knowledge and the responsibility for choosing the best sequences for any given pathology when looking for a particular symptom… but the more we can standardize it the more efficient we become,” says Mr.Barta. “With PerformanceBridge, we’ve been able to see where the variances lie.” Through Philips PerformanceBridge platform, technologists are given an action to the data and an insight to act on – whether that is room utilization or standardizing our protocols. “It showed me exactly at what times of the day I was slow and what times of the day I was busy. It gave me the ability to better schedule my outpatients in with my inpatients,” says Mr.Eslinger. “I was able to get information that showed me how we’re coordinating our rooms is wrong, that I need to create some kind of a separation between my inpatients and outpatients, to better provide to their needs.”
Measuring the goals achieved
Thanks to PerformanceBridge, Phoenix Children’s radiology cleaned up its imaging protocols – many weren’t consistent or were old and had been created by a technologist to suit their own preferences. More than 60 different exam cards were removed which were slowing the department down. It saved them time spent searching for protocols and reduced the risk of them selecting the wrong one. “In the end what it allowed for us to do was to create a consistency in our department,” says Mr.Eslinger. “It showed me exactly what protocols were being run, how long they were running for, and maybe why one protocol is working better than another one.” “We’re able now to get more information on these patients, and be able to give information to the radiologist to make better reports that change the care of these patients.” The difference between how the imaging suite operates can be measured in the efficiency that it has brought to workflows in a number of critical areas such as staffing, patient throughput and scheduling. It can also be measured by the ability they have to continuously improve the way they work: the radiology department at Phoenix Children’s Hospital can look at their data, set their own goals and meet them.
1. Imaging Performance Partnership. The Advisory Board. Accessed April 7, 2016.
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