When an injured child comes into the ED, no one wants to wait a minute longer than necessary for the radiology report, especially if there’s a suspicion of child abuse. At Children’s Hospital & Medical Center in Omaha, NE, such cases regularly present themselves, yet radiology studies often took an hour or longer from exam completion to report dictation.
When I joined Children’s radiology department in 2009, I was tasked with decreasing that turnaround time to 15 minutes. My team and I knew such a drastic reduction would require a strategic approach rather than a tactical one. Simply upgrading equipment or eliminating bottlenecks would not be enough — every process and system would have to be optimized to the highest level to meet the goal.
With the help of McKesson’s Medical Imaging Professional Services team, we conducted a thorough examination of our department workflows, integration with other departments and equipment status. We determined the following:
- Some functions were still paper-based, causing delays.
- We did not have standard hanging protocols for the variety of reading situations taking place in the department.
- We did not have the data we needed to justify investments in hardware, software or personnel.
- Our physicians were not trained on the system to the point where they could efficiently organize and share images, teaching files and reference case information.
- The rising workload in the department was not being efficiently supported by the current image viewing and storage systems (370,000 patient visits yearly and a Level II pediatric trauma center treating 40,700 patients in the ED and urgent care department).
Using a prioritization matrix from McKesson’s Optimization Services, we immediately took action to eliminate paper reports (low hanging fruit that we could quickly resolve by integrating DICOM Structured Report solution into McKesson Radiology™).
We then addressed the three areas we believed would bring the most improvement to our turnaround times:
- We upgraded our 3D reconstruction software to improve image quality and report turnaround times.
- We optimized our PACS hanging protocols to reduce radiologist workflow barriers.
- We added an FTE to the radiology team, separating the PACS admin and RIS admin responsibilities (newly gathered data helped us determine this staff addition would lead to savings in the long term).
The project was a success on all fronts. Radiology study turnaround time is now 15 minutes or less, an enormous achievement that helps patient flow and greatly contributes to patient satisfaction. Many families travel a long distance to be seen at our facility, so creating an efficient one-stop facility is essential to providing high-quality care. At the same time, radiologist satisfaction levels increased by 50%, in part because bottlenecks have been eased and our updated hanging protocols have resulted in less overall frustration with the system.
Going forward, we’re planning to further improve medical imaging sharing and workflow by deploying a vendor neutral archive. We’ll continue to focus on providing better, safer, faster care. We’ll also continue our Area Action Committee. The committee, which includes managers, providers, IT and the PACS admin, has shown us the importance of sitting down each month to prioritize the actions we plan to take the following month.
Nicole Hardin, MS, RT, is Radiology Director at 139-bed Children’s Hospital & Medical Center, Omaha, NE. View this recorded webinar and case study to learn more about McKesson Optimization Services.