Quinte Mri Case Study

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Poor communication – short/long term issue

Hand in hand with the issue of scheduling appointments, there is also a lack of information sharing within the clinic. There seems to be a bottleneck between the patient and the scheduling department where patients fail to show up for their appointments or cancel at the last minute. Additionally, barriers to communication also exist between the Radiologist and the MR Technologist because of the time lag in the Technologist not being able to provide the Radiologist with the images as soon as the MRI scan has been completed.

Environmental and Root Cause Analysis

Qualitative and Quantitative Analysis

The business of MRI scans is constantly growing in USA with a high annual scan rate of around 68/1000 people and is expected to grow even further with the increase in demand in Adelaide County. With five locations across North America, Quinte MRI was a reputed addition to the BCMC team providing 24/7 service, thus establishing a competitive advantage in the industry.

With an increase in patients requiring an MRI due to the high cancer rate, problems arose within just six weeks into servicing. One of the main issues was a decrease in productivity due to the fluctuation in the processes at BCMC. There were many issues particularly with the scheduling of the scanning operations that resulted in waiting lists and referrals to competitors due to long lead times. The scheduling process they had in place was not working as it lacked consistency and accuracy. In being a manual process, it is prone to error but because it is handled by BCMC, Quinte MRI is unable to take control of this operation. There needs to be a better method of scheduling to reduce the variability which is in turn negatively impacting the efficiency of the scanning process. The inefficiency in scheduling also boils down to only having 8 slots available for patients each day (one per hour) and with the multiple errors in scheduling whether it is with cancellations, walk-ins, incomplete forms, illegible handwriting, or ineligible MRI patients, it resulted in idle time for both the machine as well as people.

With the high demand for scans, it was very difficult for the Quinte MRI to compete with the limited capacity of the MRI machine’s functionality and one MR Technologist. Additionally, the capacity of this machine was supposed to be two scans per hour when in fact an exam takes approximately 30-45 minutes to complete and some even require an extra 15 minutes for more detailed imaging. As mentioned above, the role of the MR Technologist is also not utilized in a lean fashion driving unnecessary waste and contributing to the low productivity.

Currently, the scanning process and diagnostics process combine to create a bottleneck in the overall operations. Exhibit 1 provides a detailed analysis of the time it takes for each step of the process giving a total of approximately 38.5 minutes for 25% of patients and 30.5 minutes for 75% of patients (taking into account film sheets are not printed after every patient). The diagnosis alone then takes 306 minutes (5.1 hours). The SWOT analysis in Exhibit 2 provides a more detailed analysis on Quinte MRI’s internal strengths, weaknesses and external opportunities and threats.

Alternatives and Options

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Transfer of scheduling responsibilities to Quinte MRI

The scheduling responsibilities that are currently managed by BCMC should be transferred over to Quinte MRI so that they have more control over the process. Part of this initiative would be hiring an MR Technician who can perform some of the clerical tasks. This would allow the MR Technologist to focus on value added tasks, reducing his overtime and ensuring his retention. Quinte MRI can also recruit some high school volunteers to call patients to confirm their appointment, verify health risks and provide reminders regarding arrival time and metal components on clothing.

Pros

Cons

- MR Technologist can focus on value-added tasks

- Added salary for MR Assistant

- Revenue loss from turning patients away could cover the cost of hiring MR Assistant

- Invest in training – on the job and procedural tasks

- Back-up support for Jeff Sinclair

- Improve customer service

- Quick turnaround time for reports and scans

2. Implement a computerized scheduling system

Another alternative is for BCMC to put in place a computerized scheduling system, thus enhancing the quality of patient care. This will reduce the number of scheduling mistakes, misinterpretation of illegible handwriting and confusing schedule sheets. A digitalized software can also be used to send reminders to the patients regarding their upcoming appointment via e-mail with a questionnaire that must be submitted ahead of time.

Pros

Cons

- Less room for errors/mistakes

- Cost to implement a new software system

- More time available to improve processes and spend on value-added activities

- Cost to train receptionist and scheduling staff to operate new system

- BCMC will be updated in terms of technology resulting in more accurate scheduling

- Increase in capacity flow

- Increase in overall revenue

3. Improving the process flow for MRI Scans

Another alternative would be to improve the process flow of conducting the MRI scans to make it more tight and concise by saving time where possible. One way this can be done is to schedule MRI scans for a similar body part together so that the MR Technologist does not have to spend too much time re-positioning the coils each time. Additionally, when the diagnosis needs to be transcribed, speech to text software can be used to automatically transcribe results, thus reducing the wait time by at least three hours before the radiologist