Case Study: Methodical, data-driven approach leads to fewer delays in patient care

As the imaging community continues to focus on demonstrating value, it is as important as ever that delays in patient care be kept to a minimum. Patients who have their care delayed may feel insignificant, leading to the perception that less value is being provided.

According to a recent case study in Academic Radiology, a thorough, data-driven approach can reduce delays for interventional radiology (IR) patients and lead to more procedures beginning on time.

Monica C. Villarreal, PhD, from the H. Milton Stewart School of Industrial and Systems Engineering at Georgia Institute of Technology, and colleagues from Emory University Hospital in Atlanta, chose to tackle the problem of patient delays by forming an interdisciplinary project team. The team met weekly, mapped out inpatient (IP) and outpatient (OP) workflow, and closely examined data.

Several improvement interventions were then selected. Those interventions were:

• Creating a checklist for the preprocedure/postprocedure care area (PPCA);
• Allowing more flexibility for patient transport from the PPCA to the treatment room;
• Drawing blood at the PPCA instead of moving the patient elsewhere;
• Allowing all IR fellows to perform consent instead of just one per day; and
• Providing internet access to outside lab results by nurses in the PPCA.

To judge the effectiveness of these interventions, the team chose to focus on the first case of the day.

“Smoothing the IR workflow process and reducing delays in patient care has a direct impact on on-time procedure starts,” the authors wrote. “The first cases of the day are of special interest because a delay in the first case may cause delays in all subsequent cases for that day. They are also an ideal way to examine delays in on-time starts because they are not affected by previous cases.” 

Going by this metric, the interventions appear to have been a success. On-time starts for the first procedure of the day increased from 23 percent to 56 percent after the changes were put in place.

In addition, patient wait time between the PPCA and treatment room reduced by 10 minutes, and the number of delays in patient care per 100 patients dropped from 46.6 to 40.1.  

“Many different factors contribute to patient delays within the IR division—it is a complex work environment with both IP and OP workflows,” the authors wrote. “However, a data-driven, interdisciplinary team-based approach was an effective way to reduce such patient delays and workflow bottlenecks.”