3:00 PM Abstract No. 141 Interventional radiology patient throughput: application of lean sigma methodology and real-time delay dashboard to improve operations and patient experience

Abstract

Implementation of large scale EMRs are problematic for optimization of patient experience. A large interventional radiology center performing up to 1000 procedures every month developed a customized, unique, unit-specific patient delay dashboard with real-time feedback to mitigate patient delays. Due to various inefficiencies and limitations, 28% of outpatients are delayed more than 60 minutes past their scheduled procedure start time. The purpose of this project is to achieve a 50% short-term reduction in patient delays greater than 60 minutes and a long-term 50% decrease in delays overall. Additional areas of focus include patient experience e-survey scores, procedure room downtime, reduced PACU capacity, denied insurance days, and financial cost. A multidisciplinary team utilized Lean Sigma methodology for this quality improvement project. A computer application was developed to calculate delays using daily EMR data extracts sent via sftp to our data base. The app supplies a real-time color-coded patient delay dashboard which is prominently displayed on flat screens throughout the department, and alerts staff to individual patient delays in real time with green, yellow, orange, and red lights. A bundled set of interventions targeted preprocedure care coordination and scheduling, outpatient prerounding, reduction of the PT/INR requirement, and the development of an IR bedside service. Patient delays were reduced by 27% in the > 60 minute category (p>0.05) from a baseline 5-month period in January 2016 to a corresponding period in May 2017. Top box scores for timeliness improved 21% on patient e-surveys (n = 802). An anticipated reduction in hospital insurance denied days, due to improved throughput, facilitated funding to open an additional procedure suite and add the bedside services team. Interventions resulted in significant improvement in patient delays, patient experience scores, and denied days. The invention, design, and implementation of a real-time unit-specific dashboard supplied by a data dump from the EMR was invaluable in helping to promote team awareness and transparency regarding delays and throughput.