Quality Initiatives: Lean Approach to Improving Performance and Efficiency in a Radiology Department

Abstract

Many hospital radiology departments are adopting "lean" methods developed in automobile manufacturing to improve operational efficiency, eliminate waste, and optimize the value of their services. The lean approach, which emphasizes process analysis, has particular relevance to radiology departments, which depend on a smooth flow of patients and uninterrupted equipment function for efficient operation. However, the application of lean methods to isolated problems is not likely to improve overall efficiency or to produce a sustained improvement. Instead, the authors recommend a gradual but continuous and comprehensive "lean transformation" of work philosophy and workplace culture. Fundamental principles that must consistently be put into action to achieve such a transformation include equal involvement of and equal respect for all staff members, elimination of waste, standardization of work processes, improvement of flow in all processes, use of visual cues to communicate and inform, and use of specific tools to perform targeted data collection and analysis and to implement and guide change. Many categories of lean tools are available to facilitate these tasks: value stream mapping for visualizing the current state of a process and identifying activities that add no value; root cause analysis for determining the fundamental cause of a problem; team charters for planning, guiding, and communicating about change in a specific process; management dashboards for monitoring real-time developments; and a balanced scorecard for strategic oversight and planning in the areas of finance, customer service, internal operations, and staff development.

Developing a Performance Data Suite to Facilitate Lean Improvement in a Chemotherapy Day Unit

“…8,9,[13][14][15] The success of lean business improvement methods has been previously reported at a day oncology center in the Netherlands, where authors showed 12% increase in staff member productivity after lean process improvement 5 and in a cytosuite to reduce waste associated with process variation and error. 16 On reflection, one of the greatest benefits of this project was the development of multidisciplinary teamwork after the process mapping events, which led to a new appreciation for the constraints of each craft group and how they affected patient experience.…”

Impact of Physician Scorecards on Emergency Department Resource Use, Quality, and Efficiency

“…Balanced scorecards have been used in health care to provide a comprehensive picture of performance at the organizational level but have not been studied at the individual provider level. [25][26][27][28] The impact of providing physicians with comprehensive and balanced feedback on their practice patterns relative to peers in the same setting is not known. In this quality improvement initiative, our objectives were to develop a tool for comprehensive feedback to ED physicians on their practice patterns relative to peers and to evaluate the impact of such a physician feedback tool on ED resource use and associated ED quality measures, ED length of stay (efficiency measure), and return to ED (balancing measure).…”

Teleradiologische Prozess- und Untersuchungszeiten

“…An dieser Stelle seien einige dieser Ansät-ze kurz skizziert, die je nach Bedarf angewendet und kombiniert werden kön-nen: Z. B. haben die "lean priciples", die ursprünglich aus dem Produktionssystem von Toyota stammen, Einzug in die Radiologie gefunden [24]. Dahinter verbirgt sich das Prinzip der Elimination überflüs-siger Arbeitsschritte und Vorgänge, um dadurch eine Konsolidierung des Arbeitsablaufs auf die elementaren Schritte und eine damit einhergehende Effizienzsteigerung zu bewirken.…”