Using Plan-Do-Study-Act Can Help Radiologists Break Through, Redefine Their Role


Adapting to the Changing Role of Radiology Healthcare’s shift from fee-for-service to value-based care is redefining the role of radiology within the care spectrum. While that can be a scary proposition at the outset, it actually presents opportunities for radiology to break out of its silo, contend the authors of an article in the December issue of the Journal of the American College of Radiology.

The article, “Advanced Practice Quality Improvement Project: How to Influence Physician Radiologic Imaging Ordering Behavior,” notes that although radiologists may have lost their traditional position as imaging gatekeepers, that freedom can lead to greater collaboration with providers and an important role on the care team.

Authors Dr. Daniel J. Durand with Evolent Health and Dr. Marc D. Kohli of Indiana University advocate the use of the Plan-Do-Study-Act (PDSA) methodology as a starting point for changing the role of radiology. “By applying the PDSA framework, radiologists can incrementally optimize their practice’s consultation service,” the authors state.

PDSA is acknowledged by the Institute for Healthcare Improvement as “a useful tool for documenting a test of change.” Within the PDSA framework, SMART goal setting can be helpful in working with ordering physicians to make sure that intended actions are specific, measurable, attainable, realistic and timely. The words used for the acronym can vary (see variations at Project Smart), but the general idea is the same.

But first, get your department in order

As you know, changes happen on the fly all the time. They also happen after much planning. But how many of them truly stick? That’s why an underlying methodology such as PDSA is necessary to help good ideas and practices become standard operating procedure within a department or organization.

Before picking up the jackhammer and taking a swing at that silo, however, you must maximize the workflow within your own department. How often does your department fail to meet service level agreements (SLAs)? How can you improve internal processes to free up staff to perform value-added services that raise the stature of the department? Our latest workflow tool, McKesson Enterprise Image Workflow Intelligence™, is designed to help radiologists practice more specifically within their specialty areas and more efficiently overall to help improve service levels.

One of the common complaints we heard from radiology administrators was about the time they spent creating custom filters to distribute the work or monitoring the work list manually to keep service levels high. Our Workflow Intelligence platform is built upon a flexible rules engine that can help users adapt to changing needs and push out new workflows to all users.

Unread studies can be timed according to departmental SLAs, for example, to help boost the role of radiology. In a recent post, Product Analyst Laurie Bergeron explained it this way:

“If you have a goal of a 30-minute turnaround time for overnight ED cases, and there is a case that’s 25 minutes old, the workflow uses a flexible rules engine to move that case to a higher priority and notify the appropriate person that it is nearing SLA. Similarly for other critical cases such as stroke protocols, PE screenings, triple rule-out, trauma cases.”

Task lists can be tailored to a radiologist’s credentials, sub-specialty and facility. Studies can be assigned by such criteria as age, location, procedure type and more so that each study finds the most qualified, available reader.

The optimal workflow in your department could vary widely from the optimal flow of the radiology department across the street or across town. So it’s critical that you have customizable workflows and communication tools, including instant messaging, notification, SMS and email that can be used for assignment, escalation and reporting.

We’re excited about McKesson Enterprise Image Workflow Intelligence™ and its ability to raise the stature of radiology departments within the hospital, helping to free up physicians and administrators to perform more value-added activities that are defining the future of healthcare. For more information, please contact McKesson Enterprise Medical Imaging.

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