patients were sent to radiology early in the session, they would all return to clinic
within the session time of 3.5 hours. Clearly, the radiology department could not
cope with the imaging requirements of five patients every five minutes and this
had produced a built-in wait of two hours for some patients. This misunderstanding
was caused by lack of communication between professionals and only came to
light once a multi-professional team was tasked with redesigning the service.
The templates were changed so that appointments are now spread throughout the
whole clinic session. Where it is known that a patient requires plain film imaging
at their next clinic attendance, the request cards are written and taken to radiology
on the morning of the clinic, allowing the patient to report directly to radiology
without queuing in outpatients first. The radiology appointment is 20 minutes prior
to the outpatient appointment so that patients attend the clinic at their appointed
time with their imaging completed. The number of authorised nurse requestors
was increased for additional flexibility. These changes were implemented over the
following six weeks, resulting in:
Less walking and fewer queues for the patient;
A smoother and faster flow through radiology, with a maximum wait of 40
minutes;
A shorter orthopaedic clinic visit, the longest now being just under two hours;
The clinics finishing on time.
It was recognised that additional improvement work could streamline the pathway
further. As 69 per cent of the plain ‘film’ work carried out in the main radiology
department is referred from the orthopaedic clinic, an event was planned to
investigate the feasibility and impact of putting x-ray rooms directly into the
orthopaedic outpatient pathway. This could then free resources within the main
radiology department to concentrate on ED and inpatient work.
A planning event was held in March 2007 which focused on identifying the
best location for a DR x-ray room within the flow of orthopaedic outpatients.
Most in-patient requests are
It soon became clear that one DR room would not be sufficient, and that two
were required. The options were analysed, the preferred option was agreed and
accommodated on the day of
a future state map was created. The expected benefits include a 59 per cent
reduction in the distance travelled by the patient and a 69 per cent reduction in
referral
the overall clinic visit time. At the time of writing, the two new x-ray rooms in the
orthopaedic outpatient department are close to completion.
CT department
Having already drastically cut outpatient waiting times by conventional service
improvement means, acceptable waiting times for CT were proving difficult to
maintain. The service deals with both inpatient and outpatient demand along with
emergency referrals from the ED. There are also some one-stop clinics requiring
2009
|
IMAGING & ONCOLOGY
|
53
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64