radiation oncology report (turn-around time) committee members: najeeb mohideen, md autis speights,...
TRANSCRIPT
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Radiation Oncology Report (Turn-Around Time)
Committee Members:
Najeeb Mohideen, MD
Autis Speights, Manager Radiation Oncology
Preston Bricker, Sr. Systems Analyst
Patricia Lenkart, Transcriptionist
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Opportunity Statement and Desired Outcome
Report turnaround time for reports was approximately 4 weeks,causing a problem with reports not being available when patients returned for follow-up visits in Radiation Oncology.
Our goal is to ensure that all dictated medical documents are transcribed and distributed in a timely manner inter-departmentally as well as externally.
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Most Likely Causes for Current Opportunity
Transcription staff and faculty were located at different facilities.(Dictation tapes were transported via courier)
Computer System: Antiquated (No ability to share information electronically)
Workflow based on delivery date of tapes (Not date of service)
Staffing level not sufficient: (Ratio of transcription to physicians was 1 to 9)
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Solutions Implemented
Initial backlog of dictation was outsourced while team was working on a more streamlined process.
Transcription relocated closer to physician offices. Tape submission/courier pick-up deadlines were
reengineered to accommodate physician routine. Reduced number of drop off locations for
physicians. Physician work room and transcription mail box.
Increased number of courier pick-ups @ Loyola Clinic.
• Work flow based on date of service. Monitored date of service and delivery time.
• ROIS system was purchased and installed. Radiation Oncology Information System (IMPAC)
• Staffing level was adjusted Decreased transcription to physician ratio, 1 to 4
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Progress to Date
Original Process Process Improvement Step #1: Physician dictates initial consult Physician dictates initial consult (Loyola Clinic) Loyola Clinic/Cancer CenterStep #2: Places dictated tape in courier location Physician deliver tapes to
transcription (Loyola Clinic) McGuire Bldg
Step #3: Transport to Hines V.A. clinic Hines dictation transported from Hines One a.m. / One p.m. pick-up and drop off clinic to transcription room @ Loyola.
Step #4: Transcription pick-up tapes Dictation tapes transcribed by service date
Multiple locations
Step #5: Transcribed by delivery date Documents available in IMPAC
First in First out
Step #6: Documents transported back to Loyola Electronic physician approval Physician correction and approval
Result: 4 or more weeks to final approval Result: More efficient process and patient chart
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Results and Analysis
0
5
10
15
20
25
30
35
Before After
Before and After Intervention
Report Availability and Distribution (following ROIS implementation)
Delivery Transcription Approval
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Conclusions
Change to date of service workflow reduced overall TAT. 24-32 days to 10 days
• Streamlining key points in processes helped to further reduce TAT. 10 days to average of 5-7 days
• Implementation of ROIS system (IMPAC) allowed us to reach our goal of complete transcribed documents within 24 hours of the date of service and filed in patient record within 5-7 days. On-line viewing/edits of documents Electronic approval and signature On line access to completed documents by
clerical staff
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Next Steps Make Radiation Oncology documents
available to other physician groups through utilization of electronic medical record.
• Refine existing processes so that electronic and paperless environment can be fully implemented.
• Continue to improve TAT at Hines V.A. clinic.