In July 2018, a multi-disciplinary team was created to optimize efficiency and reduce inpatient procedure turnaround times (TATs). The majority of the Interventional Radiology (IR) Department's procedures are performed on an outpatient basis. In order to process inpatient procedures, inpatients must be worked into the outpatient schedule as openings become available. Delays in completing inpatient procedures delay inpatient discharges, increase length of stay, and increase costs. Construction caused the IR department to relocate to a smaller temporary workspace from May 2018 to November 2018.
A multi-disciplinary team was established with leadership from Interventional Radiology, Case Management, Post Anesthesia Care Unit (PACU), Nursing, and Quality to identify opportunities for improvement: procedure scheduling, outpatient recovery, peripherally inserted central catheter (PICC) line insertion, missing lab orders, and nursing knowledge of inpatient preparation for IR procedures.
By improving inpatient IR turnaround times, the project is patient-centered, positively impacts the patient experience, allows for quicker diagnosis, and has the potential to improve outcomes such as reduced length of stay and increased patient satisfaction.
Interventional Radiology inpatient turnaround time decreased 38% from July 2018 (8 hours) to December 2018 (5 hours). By recovering IR spine cases in PACU, the project saved a total of 418 hours (between September and December 2018) of IR nurse time, which was spent preparing other patients for IR procedures. This shift in care continues to save IR two hours of nursing recovery care per patient, helps to minimize delays in the IR procedure schedule, and ultimately improves patient throughput for inpatients requiring an IR procedure.
This team learned several lessons. Utilizing a multi-disciplinary approach helps to remove silos, improves communication, and promotes out-of-the-box thinking. By having the team use a neutral third party facilitate the meetings helped to maintain focus on processes instead of people.