Lean principles help interventional radiology department reduce nurse, tech OT

The implementation of "lean" principles in the interventional radiology division at the University of North Carolina School of Medicine enabled it to streamline workflow and reduce nurse and technologist overtime, according to an article in the Journal of the American College of Radiology.

The use of lean principles was first popularized by Henry Ford in the automotive industry, and has since been used in other fields--including healthcare--as a way of improving efficiency. Just last week, Peter L. Gosline, president and CEO of Monadnock Community Hospital in New Hampshire, talked to FierceHealthcare about how lean strategies saved his hospital from financial ruin after an unexpected ice storm in 2008 caused a two week power outage.

Gosline highlighted the success of the hospital's five-year "lean" journey during the American College of Healthcare Executive's 2014 Congress in Chicago, a model that he estimated has saved the organization $1 million a year.

In the case of the interventional radiology division at UNC, Ari Isaacson, M.D., and colleagues, noted in the JACR article that they had seen consistently high overtime hours and that that the problem occurred because the inpatient cases that started each day were taking too long and backing up the outpatient cases scheduled to follow.

With that in mind, the division turned to lean principles to improve efficiency. A multidisciplinary team consisting of a technologist, a nurse, a scheduler, physicians and a systems improvement expert collected data on how much time it took to complete each step of a procedure. The division then came up with three interventions--including allocating more staff members early in the day for patient transport; starting the nursing and technologists' shifts at the same time; and scheduling simpler, less time consuming interventional cases--to get inpatient cases completed on time.

According to Isaacson and colleagues, these changes reduced patient transport time and increased the number of cases completed on time, as well as the number of patients brought out of the procedure room by 9:15 a.m. Consequently, the division was able to reduce technologist and nurse overtime hours by 20 percent and 57 percent, respectively.

To learn more:
- see the article in JACR (registration required)

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