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Voice recognition software cuts radiologists’ report TAT

Prior to a performance improvement project, the radiology report turnaround time (TAT) at Florida Hospital Memorial Medical Center was 18 hours from completion of the exam to production of a report signed by a radiologist.  The answer proved to be voice recognition software, which cut the TAT to under 20 minutes in the emergency department, and to just over half an hour for inpatients.  The voice recognition software also virtually eliminated transcription costs, from the pre-implementation cost of $30,000/month to a post-implementation $300/month.

Source: Kelley, L.  Improving satisfaction and performance through faster turnaround times.  Radiology Management;33(5):38-41, Sept./Oct. 2011Click here for the journal’s website: http://www.ahraonline.org/AM/Template.cfm?Section=About_Radiology_Management1 Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

ED process improvement project decreases LWBS rate

A patient flow improvement project at Baylor Medical Center (Garland, TX) has led to a significant decrease in emergency department length of stay and the left-without-being-seen rate.  The hospital team realized that staffing and ED bed capacity were not issues; rather, it was process and procedures that were creating bottlenecks.  Among the innovations that were implemented was to shorten the triage process into a quicker screening.  Additionally, in a team approach, physicians are able to see a patient before a nurse generates the chart.  With improved signage, appropriate patients are now able to walk to radiology, for example, rather than being escorted.   Also, the charge nurse role has been revised to focus more of a managerial “traffic cop” function.

Source: Turn to staff for dramatic improvement in wait times, productivity.  ED Management;23(9):102-104, Sept. 2011.  Not available on the web.  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Akron Children’s slashes MRI wait time by 3 weeks

Using Lean Six Sigma techniques, Akron Children’s Hospital (Akron, OH, 300 beds) cut the time that outpatients have to wait for an uncomplicated MRI from about 25 days to one or two days.  It took hard work and several attempts; the first process improvements helped a little, but not enough.  But the breakthrough occurred in mid-2009.  Since then, MRI volume has increased by about one-quarter, translating into about a $1.3 million increase in revenue. 

What I like about this article:  First, they had such a dramatic improvement, resulting in measurable increases in stakeholder satisfaction, as well as in financial gains.  Second, there’s a lot of detail given about the process.  Third, there is also a description of how they improved their billing processes.

Source: Bucci, R.V., and Musitano, A.  A Lean Six Sigma journey in radiology.  Radiology Management;33(3):27-33, May/June 2011.  Published by the Association for Medical Imaging Management (800) 334-2472. 

Posted by the AHA Resource Center (312) 422-2050, rc@aha.org

Striving for Top Box: Hospitals Increasing Quality and Efficiency

This latest release in the Hospitals in Pursuit of Excellence Signature Leadership Series shares insights and best practices based on visits and interviews with three innovative health systems focused on improving both efficiency and quality of care.

  • Novant Health in North Carolina shares its experience in two areas: creating a remarkable patient experience and moving toward a payer neutral revenue system and away from cost-shifting.
  • The top box strategy of Piedmont Health in Georgia focused on physician alignment/clinical integration and on robust use of clinical data and information systems for performance measurement of cost management/efficiency and of infection control and preventable mortality.
  • The performance improvement strategy for Banner Health in Arizona centered on creating a culture of accountability, consistently communicating and measuring performance initiatives, sharing best practices across the system, and recognizing employees for performance improvement.

Recommended key elements for top box improvement include:

  • Start by addressing supplies and staffing for cost reduction.
  • Focus on incremental improvements that will snowball into big gains.
  • Address areas that will have substantial cost and quality impact.
  • Develop action plans stating crisp aims for improvement.
  • Share data transparently throughout the organization.
  • Manage with a payer neutral revenue strategy.
  • Reduce unnecessary clinical variation for quality improvement.
  • Invest in data infrastructure for frequent and detailed reporting.

Source: Health Research and Educational Trust/Hospitals in Pursuit of Excellence. Striving for top box: hospitals increasing quality and efficiency. Chicago: American Hospital Association, May 2011. http://www.hret.org/topbox/index.shtml

Best practices to reduce readmissions for heart patients

Memorial Hermann Memorial City Medical Center (Houston, TX, 427 beds) ranks among the best hospitals in the country for low readmission rates for patients with acute myocardial infarction.  This case study examines changes made in the hospital’s heart and vascular institute that resulted in substantial performance improvement.  Of key importance were changes that resulted in a decrease in door-to-balloon time down to an average of 65 minutes.  Tips on how to achieve this are included in this white paper.

Source: Memorial Hermann Memorial City Medical Center: excellence in heart attack care reduces readmissions.  Case Study: High Performing Health Care Organization [The Commonwealth Fund], Feb. 2011.  http://www.commonwealthfund.org/~/media/Files/Publications/Case%20Study/2011/Feb/1470_Lashbrook_Memorial_Hermann_readmission_case_study_web_version.pdf