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

Care IQ Group 150 years of experience in healthcare planning & engineering

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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)

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•  Introduction

•  Data treasure

•  Benchmark lessons

•  Kaizen approach

•  Examples

•  Conclusion

“You can have data without information, but… you cannot have information without data.” Daniel Keys Moran

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From “what goes wrong” to “what goes on!” and turning this into opportunities

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!)

Recognizing trends and patterns

10 Keep)measuring)to)know)that)improvement)is)durable!)

DATA PROVIDE A GOOD START FOR A MORE OBJECTIVE DISCUSSION

Lesson learned

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•  Introduction

•  Data treasure

•  Benchmark lessons

•  Kaizen approach

•  Examples

•  Conclusion

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

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•  Introduction

•  Data treasure

•  Benchmark lessons

•  Kaizen approach

•  Examples

•  Conclusion

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)

THINK BIG, ACT SMALL KAIZEN & TEAMWORK

Lesson learned

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•  Introduction

•  Data treasure

•  Benchmark lessons

•  Kaizen approach

•  Examples

•  Conclusion

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)

Scanning - start optimizing most used not the most complex exams!

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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)

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•  Introduction

•  Data treasure

•  Benchmark lessons

•  Kaizen approach

•  Examples

•  Conclusion

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)

Thank)you)for)your)a[en;on))

more)info:)andre.van.est@care:iq.com))

www.care:iq.com))