optimizing your mri practice with kaizen
TRANSCRIPT
Optimizing your MRI practice with Kaizen events
André van Est Founding Partner Care IQ Group September 2015
Outline
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• Introduction
• Data treasure
• Benchmark lessons
• Kaizen approach
• Examples
• Conclusion
Career theme: Healthcare innovation
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• 1983 – MRI development (Philips Gyroscan)
• 1988 - WS development (Gyroview)
• 1992 – Healthcare IT Apps (EasyVision)
• 1999 - MR Applications (Intera, Achieva, Ingenia)
• 2004 - Professional Services o 2004 - NetForum Community o 2006 - Utilization Services o 2008 - Consulting Services
• 2013 - Founding Partner Care IQ Courtesy)to)Philips)Healthcare)www.philips.com/ne7orum)))))
NetForum)Community)
OHSU Portland OR
NIC Las Vegas, NE
The Netherlands (Rijnstate Arnhem, 2x Catharina Eindhoven, Antonius Nieuwegein, Viecuri Venlo, Elkerliek Helmond, 9x UMC Utrecht)
Japan (Yaesu Clinics)
Austria (Neusiedl, Klagenfurt, Kapfenberg)
Denmark (2x Herlev Hosp. Kopenhagen, Herning Hosp.)
Turkey (Yeditepe University )
Saudi Arabia (NGH Riyadh, Bakhsh Hospital Jeddah)
UA Emirates (Al Zahra Hosp Sharjah)
Southern Open MRI FL
DMI Palm Springs CA
2x St Barnabas Livingston NJ
China (Renji Hospital)
Sweden (2x Lund Uni Hospital, 2x Unilabs Göteborg)
France (La Porte Verte Versailles, La Pitié Paris) UK
(North Staffs Univ Hosp.
Germany (2x BrüderKH Trier, 2x Asklepios Barmbek Hamburg, MRT Schwerin)
Norway (AHUS Oslo, Molde Hospital, Ålesund Hospital, 2x Unilabs Oslo)
60+ Kaizen Events, 300+ Quick Scans
Spain (2x La Fé Valencia)
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Switzerland (2x Unilabs Geneva)
“You can have data without information, but… you cannot have information without data.” Daniel Keys Moran
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Tracing the waste!
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Examina1on)Times)• )many)or)long)scans)• )contrast)prep)in)room))• )repeat)or)add:on)scans)• )non:coopera;ve)pat’s)
Changeover)Times)• )pa;ent)late/no:shows)• )inefficient)changeover)• )inefficient)pat.)transport))• )unplanned)slots)
Most)1me)waste)occurs)when)the)scanner)is)not)running!)
Significant)performance)varia;on)despite)similar)technology)Top)performers)more)effec;ve)in)managing)org.)complexity)
Global benchmark Philips 1.5T
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)Philips)1.5T)Systems) )) )) )) )) )) )) )) )) ))
)2013) BEL) CAN) CHI) DEN) FRA) GER) ITA) JAP) NL) SWI) SPA) SWE) UK) USA))Procedure)1me) 26) 40) 25) 43) 26) 32) 36) 39) 34) 47) 39) 46) 35) 58))Scan)1me) 17) 23) 13) 21) 16) 19) 21) 18) 18) 24) 22) 22) 20) 25))Scans)per)exam) 7.8) 8.7) 7.6) 8.1) 8.2) 8.5) 9.1) 8.9) 8.0) 8.6) 9.0) 8.5) 9.9)Source:(Philips(U0liza0on(Services))
1.5T)Germany)by)prac1ce)type)
Procedure)1me)
Mean) Best)
Private) 31) 16)
Hospital)<500)beds) 43) 21)
Hospital)>500)beds) 52) 20)
Academic) 64) 20)
PRACTICE OPTIMIZATION REQUIRES A SOUND MIX OF PEOPLE, PROCESS AND TECHNOLOGY, PLUS CAREFULLY FACILITATED CHANGE
Lesson learned
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change
Data is not information, Information is not knowledge, Knowledge is not understanding, Understanding is not wisdom. Clifford Stoll
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How to get started?
Question the status quo! • Measure – Voice of the data • Interview – Voice of the people • Observe – Voice of the process
© Care IQ Group BV 17
How to get results that stick?
• Involve the team to inspire commitment • Do it swiftly and focused ! Kaizen
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: Iden;fy)issues)): Analyze)root)causes): Iden;fy)solu;ons): Priori;ze)solu;ons): Implement)solu;ons)
5 day Kaizen event
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• Team work • Fact based • Solution driven • DMAIC
)Deliver)
)Report)
)Interpret)
)Exam)
)Perform)
)Exam)
)Prepare)
)Exam)
)Receive)
)Pa1ent)
)Confirm)
)Exam)
)Schedule)
)Exam)
Receive)
Order)
Quality))of)care)
Cost)effec;veness)
Pa;ent)&)Staff)experience)
KAIZEN)EVENT)
Keep the schedule simple!
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Before:)li[le)flexibility)due)to)many)‘reserva;ons’)
A^er:)more)flexibility)and)capacity,))more)autonomy)for)scheduling)staff)
Clear space, clear mind! Issues • Clutter in the scanner room, e.g. coil
and accessory storage, sterile goods, contrast materials, blankets, etc.
• Excessive amounts • Unnecessary materials • Dirty laundry and waste Solution
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Before)
A^er)
Timely contrast prep outside room saves 3-5 min per exam!
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Common issues • Patient prep starts too late • Patient being anxious • Contrast prep inside room Opportunities to add value • Tech-aide to help maximize
technologist time • Personal contact to educate
patient about exam or handle anxiety
• Scan execution reports shows impact of in-room prep
5 min inter-scan delay
Tech aide - avoid being penny wise pound foolish
Issue: • High volume (30 ex/day) • Single operator, stress! • Invest in staff? Solution: • Introduce tech aide to
assist with patient prep (shared with CT suite)
Results: • Productivity +10%
• Quick ROI • Staff satisfaction "
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Preparation – two birds one stone or tackling no-shows effectively
Issue: • High no-show rate (9%) due to
patient ‘shopping’ behavior Solution: • Introduce ‘reminder’ calls & script • Overcoming ‘no time’ syndrome Results: • No-show rate from 9% to 3% • Effective use of shift overlap
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Pa;ent)present)
Pa;ent)no:show)
Utilize the technological advances
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Before) A^er)
Issue • Knee ExamCard not updated after major system upgrade • Untapped technological advances Solution • New method technology applied (asymmetric-TSE) • 30% time gain, average scan time reduced by 5 min
50%)peak)
25%)peak)
Leverage the combined team skills
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Before)
Issue • 2D strategy often leads to add-on scans (i.e. extra spine levels) • Lack of ownership and team play Solution • 3D strategy automatically covers larger field of view • More robust and predictable ExamCard execution
20%)peak)
80%)peak)
A^er)
Conclusion
Data)
Informa;on)
Knowledge)
Understanding)
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Wisdom)Ac;on)
experience)
applica;on)
Data is not information, Information is not knowledge, Knowledge is not understanding, Understanding is not wisdom.)Clifford)Stoll)