ABSTRACT
INTRODUCTION/BACKGROUND: Within radiology departments, alignment of available imaging capacity with demand across different patient groups helps ensure that all patient populations are receiving timely and equitable care. The objective of the MRI Schedule Optimization project was to implement a 5-step framework to review and update the current MRI schedule templates at the Joint Department of Medical Imaging (JDMI) to ensure optimal alignment with demand across patient populations. METHODS: The project, governed by clinical and clerical stakeholders and operational leadership (Owners), followed a 5-step process: (1) Analysis of baseline data related to MRI demand and current schedule composition (2) Current state assessment of MRI operations via interviews and observations (3) Updating of schedules to align with demand (4) Review of process improvement opportunities (5) Go-live planning and evaluation. RESULTS: Current state analysis revealed that misalignment of the original schedule with demand was as high as 11% for some divisions. Updated MRI schedules were implemented with a maximum variance from demand of 3%. The updated schedules also allocated 27 additional inpatient slots to respond to inpatient demand. In addition, several process improvement opportunities were identified and implemented to streamline scheduling processes, day of exam workflows and inpatient workflow management. DISCUSSION/CONCLUSION: The MRI Schedule Optimization project followed a structured framework to comprehensively review and realign the MRI schedules at JDMI to the needs of our patient population by improving access and identifying process improvement opportunities. This scheduling framework can be applied to perform similar schedule update exercises at any radiology department.
Subject(s)
Appointments and Schedules , Radiology Department, Hospital , Humans , Workflow , Magnetic Resonance ImagingABSTRACT
INTRODUCTION/BACKGROUND: A peer learning program includes the process of peer review, which is the act of performing a secondary review of a peer's work using pre-defined criteria. The Technologist Image Quality Assessment Criteria Project (TIQACP) was initiated to develop and evaluate such criteria for use by technologists for assessment of image quality in Nuclear Medicine (NM). METHODS: A NM clinical expert panel was assembled, comprising 14 technologists, radiologists, and educators from five imaging centres and an academic institution with associated medical imaging training programs. Project design was guided by consensus-based methodology that included three phases: (1) image quality assessment criteria development, based on literature search and expert review (2) image quality assessment criteria refinement, based on consensus-building exercises (panel surveys, discussions, ranking exercise, and time trial) (3) external validation performed via a national survey of NM technologists, facilitated by the Canadian Association of Medical Radiation Technologists. RESULTS: The first phase generated 8 key evidence sources, including textbooks, NM journals and guidelines from professional associations that were reviewed by the expert panel leads and led to a preliminary list of 11 criteria. As part of the second phase, the preliminary list was reviewed via online surveys and panel discussions. Preliminary discussions led to an initial expansion of the list to include 18 criteria. This list required an average of 9 min (range: 7-11 min) for review, which was deemed prohibitive by the panel. A ranking exercise identified 'all required anatomy is clearly identified' as the most relevant criteria and 'Image quality demonstrates no breakdown of the radiopharmaceutical' as the least relevant criteria. Panel discussion also highlighted need to eliminate criteria that were not applicable to all settings. These insights led to an updated list of nine criteria organized into four categories. National validation was supported by 47 NM technologists from across Canada. Respondents were in agreement that the criteria reflected the core elements of image quality in NM (94% agree to strongly agree), were familiar (97%) and were relevant to their current practice setting (88%). The final list was thus not changed based on the survey. DISCUSSION/CONCLUSION: The TIQACP utilized an inclusive process that engaged a range of subject matter experts and the broader NM community to ensure buy-in of the final criteria. These criteria have subsequently been embedded in peer review software that has been implemented into a robust peer learning program for technologists designed to promote a culture of continuous improvement and knowledge sharing amongst front-line staff.
