2:50 PM Abstract No. 149 - Use of lean business tools to improve interventional radiology pre-procedure delays

Abstract

Purpose To report the use of Lean process improvement tools in an interventional radiology environment to reduce pre-procedure delays and reduce time from registration to “in-room readiness”. Materials and Methods We designed and carried out an A3-driven rapid improvement event (RIE) in a shared interventional radiology (IR) and neurointerventional radiology (NIR) environment, tracking workflow from outpatient registration to preparedness in the recovery room. The A3 processes were customized to IR needs. HI-IQ, was used to evaluate patient tracking times at baseline, during RIE, and follow-up. Outcomes were measured at 15, 30, 60, 90, and 150 days. Contributing factors were identified in root cause analysis, step 2 in a traditional A3 Process, step 4 (Gap analysis) in the modified A3. Results The A3 Process and the RIE were successfully completed. A total of 1314 encounters were included by 150 days. Mean arrival time to ready time was 76 minutes at baseline, 49.5 minutes at the completion of the RIE at 15 days, 83 minutes at 30 days, 58 minutes at 60 days, 57 minutes at 90 days, and 59 minutes at 150 days. Completed charts on arrival, a contributing factor to delays identified in root cause analysis in the A3 Process, began at 74%, and at the completion of the RIE after changes in charting procedures was 79% at 15 days, 72% at 30 days, 86% at 60 days, 84% at 90 days, and 84% at 150 days. Conclusion This Lean A3-driven RIE process resulted in clear process improvements and efficiencies in IR patient processing. This methodology is readily customized to IR environments and can be used to address multiple clinical processes. Our experience has shown a sustainable benefit in pre-procedure efficiency. The RIE and A3 Process, and other Lean tools, can be repeated to continually improve processes.