DEMAND AND CAPACITY; A WORKSHOP OF IDEAS
By Sophie Hodgson, University Hospital Coventry and Warwickshire
Objective:
It is well known that ultrasound services in the NHS are in crisis, with an imbalance of demand and capacity. In a busy University Hospitals NHS Trust this is not an exception and a Rapid Process Improvement Workshop (RPIW) was set up to address waste and identify opportunities to improve efficacy. We want to share the experiences of our workshop, ‘The outpatient ultrasound pathway from referral to report received’.
Methods:
The RPIW used principles and methods from the Virginia Mason Institute, and a team who perform the processes were assigned to the five-day workshop. The team were empowered to identify opportunities to eliminate or reduce waste within a ‘Value Stream’. A process flow was identified and real-time data captured, including detailed timings within the process, the demand of the service, and the capacities available. Quality defects were highlighted and prioritized with baseline metrics, and targets were set. Ideas were generated among the team and tested in the department against the baseline data.
Results:
The Value Stream captured all the data, with total Value Added and Lead Time calculated at 0.01% and 89 days, respectively. Our tests demonstrated that by simplifying how referrals are uploaded we could save 125 hours of ‘wait-time’. We found that a robust vetting process could prevent 10% of patients being cancelled due to incorrect preparation or, due to allocation to a sonographer without the necessary skills mix. Using the BMUS and locally agreed Vetting Standards, we found that 20% of patients have incorrect, unjustified, or duplicate ultrasound referrals. Finally, we recognized a specialized department within the Trust with the potential to assist with the demand and capacity disparity.
Conclusion:
This RPIW has potential to improve the quality of our service and help address the crisis currently being faced in many departments.