Improving Turnaround Time in a Hospital-based CT Division with the Kaizen Method.

The Kaizen method is an approach to lean process improvement that is based on the idea that small ongoing positive changes can lead to major improvements in efficiency and reduction of waste. The hospital-based CT division at Mayo Clinic Arizona had been receiving numerous concerns of delays in the performance of examinations from inpatients, outpatients, and patients presenting to the emergency department. These concerns, along with a planned hospital expansion, provided the impetus to perform a process improvement project with the goal of reducing inpatient, emergency department, and outpatient turnaround times by 20%. Kaizen process improvement was chosen because of the emphasis on reduction of waste, standardization, and empowerment of frontline staff. The project was led by a process improvement coach who was trained in lean process improvement and A3 thinking. At the end of a weeklong Kaizen event, inpatient turnaround time decreased by 54%, emergency department turnaround time decreased by 29%, and outpatient turnaround time decreased by 45%. These results were achieved and sustained by establishing standardized work, developing frontline problem solvers, instituting visual management, aligning with relevant metrics, emphasizing patient and staff satisfaction, and reducing lead time and non-value-added work. When done properly, a Kaizen event can be an effective tool for process improvement in the health care setting. Online supplemental material is available for this article. ©RSNA, 2022.

Never Events in Radiology and Strategies to Reduce Preventable Serious Adverse Events.

The term never event in medicine was originally coined by Kenneth W. Kizer, MD, MPH, former chief executive officer of the National Quality Forum, to describe particularly shocking medical errors that should never occur, such as wrong-site surgery or death associated with introduction of a metallic object into the MRI area. With time, the National Quality Forum's list of never events, or "serious reportable events," has been expanded to include adverse events that are unambiguous, serious, and usually preventable. In this article, the never event framework has been used to describe (a) the errors that may occur in an imaging department that are serious and usually preventable with a review of the causative factors and (b) strategies to eliminate and reduce the adverse effects of these avoidable errors. These errors are often rooted in communication breakdowns and can only be eliminated with a true shift to a culture of open reporting and patient safety. ©RSNA, 2018.