Even though 98% of surveyed imaging leaders ranked this issue as a top priority, identifying and addressing imaging bottlenecks remains a challenge. That's partly because collecting meaningful workflow data using picture archiving and communications systems (PACS) and EHR resources is logistically challenging and imprecise.
Johns Hopkins Medicine improved imaging throughput and efficiency by using a real-time location system (RTLS) in its breast imaging outpatient clinic. Here's how Johns Hopkins Medicine identified key bottlenecks around staffing, equipment, and communication among technicians—and how you can use the findings to improve imaging efficiency in your own clinics.
RTLS identifies 2 key bottlenecks for Johns Hopkins
RTLS automatically collects location data for patients and staff using infrared (IR) identification (ID) and radio frequency communication. Johns Hopkins Medicine installed IR monitors throughout its clinic and provided RTLS-monitored ID badges to its imaging staff and patients when they check in. These badges have a unique ID code that provides location data every three seconds to the IR monitors, allowing for real-time tracking.
Using this system, Johns Hopkins Medicine diagnosed two key bottlenecks in imaging throughput: inefficient communication and insufficient equipment. The organization found that the Digital Breast Tomosynthesis (DBT) exam room is the most utilized, with the highest average wait time at 30 minutes—more than that for an ultrasound or stereotactic biopsy. It also found that 42% of the time when patients are waiting to enter an empty exam room, the technologist is either in the hallway or with another patient, suggesting a need for additional staff and better methods for communication.
Next steps for service line leaders
While RTLS can be a worthwhile investment to identify facility-specific bottlenecks and implement data-based decisions for some facilities, the holdups that Johns Hopkins identified are consistent across many imaging centers. That means many centers can benefit from simple alterations to staffing and communication. Here are three tactics that can improve throughput:
- Use multiple technologists: One way to maximize throughput is to use a multi-tech staffing model to ensure machines are operating non-stop. While one technologist prepares and escorts the patient to the scan room, the second technologist remains in the scan room operating the imaging equipment. The two can exchange positions periodically to prevent burnout.
- Ensure continuity across the patient visit: While staffing multiple technologists increases the number of scans that can be done in an hour, it has the risk of the patient feeling passed around, potentially leading to dissatisfaction. To address this concern, each tech can be assigned a particular patient to guide through prep, scan, and post-scan activities. By "owning" the patient, techs are able to eliminate extra handoffs or communication concerns that arise when transferring a patient from one staff member to another.
- Streamline communication: Simple changes to optimize communication within the imaging department can also eliminate inefficiencies. For example, in one hospital, staff in the waiting area flip a light switch to indicate the patient is ready for a particular modality, triggering an indicator light in the specific modality suite. A modality tech then comes to retrieve the patient. While simple, this system eliminates phone calls and trips made back and forth, saving minutes in the process.