Applying Systems Engineering Reduces Radiology Transport Cycle Times in the Emergency Department
نویسندگان
چکیده
INTRODUCTION Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time. We sought to investigate the impact of systems engineering science targeting ED radiology transport delays and determine the most effective techniques. METHODS This prospective, before-and-after analysis of radiology process flow improvements in an academic hospital ED was exempt from institutional review board review as a quality improvement initiative. We hypothesized that reorganization of radiology transport would improve radiology cycle time and reduce waste. The intervention included systems engineering science-based reorganization of ED radiology transport processes, largely using Lean methodologies, and adding no resources. The primary outcome was average transport time between study order and complete time. All patients presenting between 8/2013-3/2016 and requiring plain film imaging were included. We analyzed electronic medical record data using Microsoft Excel and SAS version 9.4, and we used a two-sample t-test to compare data from the pre- and post-intervention periods. RESULTS Following the intervention, average transport time decreased significantly and sustainably. Average radiology transport time was 28.7 ± 4.2 minutes during the three months pre-intervention. It was reduced by 15% in the first three months (4.4 minutes [95% confidence interval [CI] 1.5-7.3]; to 24.3 ± 3.3 min, P=0.021), 19% in the following six months (5.4 minutes, 95% CI [2.7-8.2]; to 23.3 ± 3.5 min, P=0.003), and 26% one year following the intervention (7.4 minutes, 95% CI [4.8-9.9]; to 21.3 ± 3.1 min, P=0.0001). This result was achieved without any additional resources, and demonstrated a continual trend towards improvement. This innovation demonstrates the value of systems engineering science to increase efficiency in ED radiology processes. CONCLUSION In this study, reorganization of the ED radiology transport process using systems engineering science significantly increased process efficiency without additional resource use.
منابع مشابه
Integrated Intelligent Information and Analytical System of Management of a Life Cycle of Products of Transport Companies
Developed an integrated intellectual computerized system of ecological-economic monitoring, modeling, and managing the life cycle of the products of technogenic enterprises of transport engineering, which is presented in the form of a 3-equation structure, functioning in conditions of instability. The proposed paradigm system life cycle management applicable to any other control system of large...
متن کاملA Mathematical Model for Scheduling Elective Surgeries for Minimizing the Waiting Times in Emergency Surgeries
The ever-increasing demands for surgeries and the limited resources force hospitals to have efficient management of resources, especially the expensive ones like operating rooms (ORs). Scheduling surgeries including sequencing them, assigning resources to them and determining their start times is a complicated task for hospital managers. Surgery referrals usually include elective surgeries that...
متن کاملبررسی شاخصهای زمان سنجی در بخش اورژانس بیمارستان فیروزگر تهران: 1391
Introduction: The speed of service delivery in health care systems, particularly in emergency centers, is crucial to reduce mortality and disability rates. One of the indicators used to evaluate the emergency departments is patients’ waiting time for receiving diagnostic/treatment services. This study aimed to measure the timing indicators in the emergency department at Firoozgar hospital. ...
متن کاملPower System Reliability Analysis with Emergency Demand Response Program
With the development of restructured power systems and increase of prices in some hours of day and increase fuel price, demand response programs were noticed more by customers. demand response consists of a series of activities that governments or utilities design to change the amount or time of electric energy consumption, to achieve better social welfare or some times for maximizing the benef...
متن کاملPower System Reliability Analysis with Emergency Demand Response Program
With the development of restructured power systems and increase of prices in some hours of day and increase fuel price, demand response programs were noticed more by customers. demand response consists of a series of activities that governments or utilities design to change the amount or time of electric energy consumption, to achieve better social welfare or some times for maximizing the benef...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 18 شماره
صفحات -
تاریخ انتشار 2017