An ongoing goal of radiology departments is to improve workflow efficiency and productivity. The Interventional Radiology Division at the University of Louisville Hospital in Kentucky increased throughput of subcutaneous port placement in patients by implementing fast-track registration. They described their achievements in the January issue of the Journal of Vascular and Interventional Radiology.
The project began with an assessment by a multidisciplinary team of the procedures performed in the Interventional Radiology Division that had the lowest expected variability. The team included physicians, nurses, and administrative staff. The authors selected improvement of the subcutaneous port placement because it is a procedure with minimal variability between patients and was frequently performed. They wrote that the rationale to select the most consistent procedure increased the chances that any difference between cases was most likely due to differences in periprocedural events rather than the procedure itself.
All patient-staff interactions with port placement patients were recorded in detail. From this information, the team determined that moving patient registration from the general radiology waiting room to the vascular waiting room ranked highest in both ease of intervention and expected workflow improvement benefits. The existing process consisted of giving the patient a pager upon check-in that would buzz when it was time to complete registration and payment information. The patient would then be escorted to the IR waiting area. The new fast-track procedure took the patient directly to the IR waiting area to complete registration with a nurse after initial check-in at the radiology department’s front desk.
Data were collected for 29 patients assigned to the fast-track procedure and 33 patients assigned to the conventional procedure. Data included time of arrival at each location, beginning and end times of informed consent, time to perform peripheral intravenous line placement, laboratory test draw and return times, and laboratory test type and results.
The fast-track registration procedure reduced the average start time from an average of 63 minutes to 33 minutes. The total time spent at the facility was reduced by nearly 40 minutes, to approximately 3 hours. More consistency was achieved was also achieved with respect to patient time spent in recovery, although the mean time of 63 minutes was the same for both groups.
Another potential area of improvement was identified in this exercise. Laboratory test completion ranged from 38-59 minutes. Lead author David P. Duncan, MD, noted that employing a handheld blood analysis device would significantly reduce the time to a matter of minutes. He told Applied Radiology that the Interventional Radiology Division permanently implemented fast-track registration.
Improving efficiency with fast-track patient registration. Appl Radiol.