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Healthcare costs are steadily rising and physician and hospital staff are experiencing post-pandemic burnout in rates not seen in decades. For radiology department heads, the pressure is on to increase efficiency while maintaining high levels of patient satisfaction.
Workflow studies have consistently identified the CT room as a bottleneck, so optimizing the throughput of the scan room is a smart first move.
Here are 5 ways you can optimize imaging room scheduling:
1. Minimize the effect of patient no-shows and last-minute cancellations
Patient no-shows are a considerable source of inefficiency in health care, with estimated costs in the hundreds of millions per year [1]. Automated appointment reminder systems or live calls to patients are a proven behavioral intervention, demonstrating significantly reduced patient cancellations and providing a lasting cost benefit. Provide an appropriate time buffer (2-3 days before the appointment) is built in, and clear contact details (phone and email) for easy rescheduling or cancellation.
Good coordination with central office can help to ease the effect of no-shows, by scheduling patients to build a buffer of work for the scan room. The idea is to budget slightly less time per patient than needed, which reduces the impact of a no-show by allowing the extra time to be made up. Given an average scan time of approximately 15 minutes [2], this would not unduly increase patient waiting time.
2. Separate therapeutic procedure times (biopsies, ablations, percutaneous punctures, etc.) from diagnostic times
Diagnostic procedures such as routine scans are typically homogeneous in time required, which means they are easy to schedule. Therapeutic procedures, in contrast, typically have a wider time range, especially when a double oblique angle is required to hit the target. Leverage this knowledge when scheduling, so that diagnostic procedures are scheduled in a block earlier in the day, and therapeutic procedures are separated.
Separating the procedures by type also allows you to optimize the type and number of personnel required.
3. Look critically at workflow efficiency during minimally invasive procedures
For complex procedures, reducing the number of steps can bring big gains. Here a workflow diagram can be of use, identifying steps which can be performed outside of the scan room (such as fluid injections, after care, and consultations) and allowing for better CT machine utilization.
An often overlooked piece of workflow efficiency is physical space, as large or bulky equipment in the scan room can cause radiographers to take longer getting to and from the patient - or in worst case scenarios, cause accidents. Consider taking a critical look at how your physical space is arranged, to see if unnecessary equipment might be causing inefficiencies.
4. Use radiology staff resources wisely
Technicians are the backbone of interventional radiology departments, so make sure yours are thriving. A positive atmosphere, involvement in decisions, and meaningful integration into the clinical aspects of their work all help staff to feel valued and expand their competencies.
Aside from the scanner itself, staff costs comprise the highest cost proportion in the CT scan room. Therefore, a critical look at the tasks each staff member is being asked to perform can generate cost savings. In general, staff should be performing at the top of their knowledge ability. Cross training staff so that each member of staff is able to assist with all procedures can improve the flexibility as well as job satisfaction [2]
Additionally, CT navigation support may enable more junior radiologists to perform complex procedures without impacting outcome or timing.
5. Reduce variance in procedure time
As mentioned above, variance in procedure time is a major driver of delays in the scan room, because of the difficulty in predicting the duration of a procedure. Here, navigational aids for difficult access routes can also be of use, potentially reducing the difference in procedure duration, even when double oblique angles make access difficult.
Keeping Patients at the Center
Ultimately, patients are at the heart of all we do, so we’ll close with some interesting results of the European Society of Radiology’s recent survey on patient satisfaction in radiology [3]. The survey found that what matters to patients is far broader than waiting times. The right diagnosis, suitably qualified staff, and time to directly engage with radiologists were also high on the list of priorities.
The good news: none of this needs to take place in the CT room.
References
1. McLean SM, Booth A, Gee M, Salway S, Cobb M, Bhanbhro S, et al. Appointment reminder systems are effective but not optimal: Results of a systematic review and evidence synthesis employing realist principles. Patient Prefer Adherence. 2016;10:479–99.
2. De Mast J, Kemper B, Does RJMM, Mandjes M, Van Der Bijl Y. Process improvement in healthcare: Overall resource efficiency. Qual Reliab Eng Int. 2011;27:1095–106.
3. Fuchsjäger M, Derchi L, Hamm B, Brady AP, Catalano C, Rockall A, et al. Patient survey of value in relation to radiology: results from a survey of the European Society of Radiology (ESR) value-based radiology subcommittee. Insights Imaging. Springer Science and Business Media Deutschland GmbH; 2021;12:6.