السبت، 8 أكتوبر 2011

Quality improvement report















BMJ Qual Saf doi:10.1136/bmjqs.2010.049643
  • Quality improvement report

Reducing MRI access times by tackling the appointment-scheduling strategy

+ Author Affiliations
  1. 1Quality and Process Innovation, Academic Medical Center, Amsterdam, the Netherlands
  2. 2DLS Product development, Delta Lloyd, Amsterdam, the Netherlands
  3. 3Radiology, Academic Medical Center, Amsterdam, the Netherlands
  1. Correspondence to Jasper R C van Sambeek, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, the Netherlands; jvs@berenschot.com
  • Accepted 16 June 2011
  • Published Online First 7 October 2011

Abstract

Background High access times for MRI facilities have a negative impact on quality of care and patient service. Since these resources are both scarce and expensive, better utilising the capacity is the most economical way of reducing these access times. As a rule, patient appointments are not scheduled efficiently. Consequently, the most promising way of reducing access times is to optimise the scheduling strategy. The aim of this study was to reduce MRI access times by optimising the scheduling strategy and by implementing this strategy in practice in a university hospital in the Netherlands.
Assessment of problems The scheduling process was analysed to define the improvement potentials and to simulate the process. Computer simulation was used to copy the process and experiment with scheduling strategies in theory. Promising scenarios were defined and run in the simulation model. Based on the simulation results, a new scheduling strategy was designed and implemented.
Results of assessment The simulation experiments showed that block reduction leads to a maximum decrease in access time of 93%.
Strategies for change Implementing a scheduling strategy with a practically applicable minimum number of blocks resulted in an actual decrease from 36, 22, 28, 9 and 9 to 7, 2, 10, 3 and 1 calendar days, respectively, depending on the patient group.
Lessons and messages This study proved that modelling the scheduling process can contribute to optimising the scheduling strategy, which can lead to a reduction in access times for imaging facilities such as MRI scanners
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