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PFC 2005 - Diagnostics and investigative services
Page contents: Aim | Change Concepts | Key Change Principles | Measures | Resources | Toolkits | Training | Websites and links
Aim
To increase timelines of diagnostic / imaging services
Change Concepts
- Redesign process to eliminate hands off, waste and complexity
- Implement 'daily' performance monitoring
- Redesign admin, booking and scheduling systems
- Increase scope and skills of radiology team, develop non-clinical staff as radiology technicians, develop consultant radiographer roles and extend scope of professional groups via development and protocols
- Develop electronic communication between primary care, in patient requests and radiology department
- Develop multi-skilled radiology administration and portering team
- Maintain permanent portering staff in radiology
- Develop and redesign request forms with supporting training, information and feedback
- Develop Protocols to support requests
- Develop training protocols for nurse and junior medical officer requests for diagnostic investigations
- Promote review of waiting times policy and service capacity - develop target waiting times for inpatient, emergency and outpatient waits
- Develop triage criteria, providing clinical feedback to strengthen appropriate referrals
- Review radiology capacity and demand for emergency department
- Implement PACS for management for radiology film
- Review radiology role in operating room
- Review schedule for inpatients needing radiology
- Identify out patient, emergency department and inpatient demand expectations and review provision
- Develop service model to incorporate 'whole systems' health care delivery covering emergency, inpatient and out patient priorities
- Implement daily review of inpatients that have radiology request to reduce patient's length of stay
- "Emergency next day slots to be booked by ED O/N - linked to OPD next day
- Review Radiology opening times, staff coverage and equipment use
- Identify radiology strategic plan and order of modality review
- Develop patient involvement strategy - i.e. posters, wipe boards, interviews
- Establish daily coordinator role for radiology dept
- Provide two-way radios for porters, administrative and radiology staff
- Target, lost capacity due to staff shortage or patients failing to attend
- Balance schedule demand; Emergency, Inpatients, and Outpatients
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Key Change Principles
- Match tasks to appropriate area/equipment
- Manage flow by aligning streams of demand
- Develop solutions for constraints
Measures
Program Measures
- Capacity and Demand
- Existing Capacity v Utilisation v Number Waiting
- Cancellation rates (Hospital and Patient initiated)
- Did no Attend (DNA) rates per day/week
Resources
 CT Screening for Cancer (58kb, pdf)
Diagnostic Radiology (157kb, pdf)
Diagnostic Testing in ED (219kb, pdf)
Halting the Growth in Diagnostics (92kb, pdf)
Radiology a National Framework (143kb, pdf)
The STARD Initiative (163kb, pdf)
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Toolkits
 Diagnostics and investigation services (2.33mb, MS Powerpoint)
Training
- Process mapping
- Human dimensions to change
- Capacity and demand
Websites and Links
Modernisation Agency, UK - Secondary Care
National Electronic Library for Health, UK
Agency for Healthcare Research and Quality - Health Care Research and Quality Improvement
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