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Published on: December 19, 2017
Increasing Patient Access to MRI Examinations in an Integrated Multispecialty Practice
Daniel S Bor1, Richard E Sharpe1, Eric K Bode1
1From the University of Colorado Denver, Denver, Colo (D.S.B); Department of Medical Imaging, Kaiser Permanente Colorado, Denver, Colo (D.S.B., K.H); Department of Medical Imaging (R.E.S., E.K.B.) and Departments of Internal Medicine and Geriatrics (W.S.G.), Colorado Permanente Medical Group, Denver, Colo; and Department of Radiology, Mayo Clinic, 5881 E Mayo Blvd, Phoenix, AZ 85054 (R.E.S.).
Abstract:
A multidisciplinary team evaluated and improved the MRI processes within the authors' integrated health care system, with the aim to increase patient access to MRI. The authors created a SMART (specific, measurable, achievable, relevant, and time-based) goal of decreasing the average number of days to wait for MRI examination by 50%, from 15 to 7.5 days, while also creating capacity to meet demand for same-day and next-day MRI appointment requests. The current performance metrics and processes were compared with available benchmarking and best practice data. Several work groups were created to empower and support frontline teams to identify and capture improvement opportunities. Across all MRI processes, teams focused on creating standard work, advancing practice to top of scope, removing waste, improving communication, reducing rework, and improving patient experience. Patient access to MRI was monitored, measured as the average number of days to wait from the time of scheduling to the MRI examination and time to the third-available appointment. The authors also monitored secondary outcomes (patient satisfaction, throughput metrics) and a balancing measure (technical repeat examination rates). The access improved after intervention: the average number of days to wait for MRI access decreased from 14.2 days to 5.8 days after the intervention (-8.4 days, -59.2%, P < .0001) and third-available appointment decreased from 18 days to 0 days. Ten to 20 same-day and next-day appointments became routinely available. The throughput metrics improved, and balancing measures were not changed. This project resulted in significant improvements in patient access to MRI examinations. The findings demonstrate the value of a multidisciplinary team applying comprehensive improvement strategies to increase patient access to complex services, such as MRI. ©RSNA, 2021.
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