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A&C Role Development

A&C Role Development. Yorkhill’s MRI Service. Lorraine Peebles, SIM, Diagnostics, NHSGGC. 31 Mar 10. Once Upon a Time……. Concern about MRI department’s ability to transform its resources effectively to reduce waiting times for patients MRI PATIENT JOURNEY MRI REFERRAL PATHWAY.

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A&C Role Development

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  1. A&C Role Development Yorkhill’s MRI Service Lorraine Peebles, SIM, Diagnostics, NHSGGC 31 Mar 10

  2. Once Upon a Time…… Concern about MRI department’s ability to transform its resources effectively to reduce waiting times for patients MRI PATIENT JOURNEY MRI REFERRAL PATHWAY

  3. The Way We Were! • Roles and responsibilities within MRI department blurred – Radiographers doing A&C tasks (booking beds, theatre time, Anaesthetists/OP appts and cancelling appts) Imaging Assistant duties inappropriate (mostly clerical) • MRI reception area not staffed and Telephones on answering machine • Cancelled Appointments not being re-used – capacity being wasted (GA appts) • Referral demand not being managed – eg, no emergency slots identified • Patient clinical and safety information from Referrers often inadequate • No agreed Appointment templates • Data and information being captured in two separate IT systems • Theatre staff, Ward staff and Imaging staff unsure of their responsibilities in relation to input of data • No joined up working between MRI, Anaesthetics and Day Care • Prospective anaesthetic rotas sometimes unavailable

  4. Over-arching Objectives • Seamless, high quality MRI patient journey for inpatients, day cases and outpatients • Increased throughput and utilization of GA MRI sessions by managing the referral pathway and associated data effectively

  5. Tool used : RIE • Rapid Improvement Events are part of the Lean 'toolkit' and provide a mechanism for making radical changes to current processes and activities (patient pathways) within very short timescales. "The power of RIEs comes from the combined talents of cross functional teams being focused on achieving specific goals in relation to bottom line, operational improvements" - Andrew Scotchmar, Data Analyst, East Lancashire Health Economy

  6. Selling the RIE Tool! • Why we needed to change • What did we need to change • Baseline of the current performance and trajectory of where we think this new model would take us – 4 weeks! • High profile executive leadership and management buy-in • Key Stakeholder buy-in • Champions within the MRI team to drive the transformation

  7. NHS Institute for Innovation and Improvement “Optimising roles along an agreed pathway of care leads to significant improvements for staff and patients in key areas”:

  8. Reducing delays in patient journey Reduction in waiting times Improve patient services Tackle staff shortages Increase job satisfaction by developing and amending roles Benefit entire Health Care Team – Support Workers to Medical Workforce Improve quality and flow of patient journey To attract and retain an effective workforce Role Development/Design

  9. Approach to RIE Key Components which together make up the Integrated Patient Journey Increased throughput and utilisation of MRI Sessions SEAMLESS Specialty Referral Referral Access Managing Demand Acquisition Reporting/ Verification Report to Specialty Referrer

  10. Areas for Improvement • Referral access • Vetting • Acquisition • Reporting • Data management MRI REFERRAL COORDINATOR to provide continuity & work closely with Supt Radiographer

  11. CURRENT SPLIT OF DUTIES RELATING TO THE REFERRAL PATHWAY AND PATIENT JOURNEY

  12. PROPOSED SPLIT OF DUTIES RELATING TO THE REFERRAL PATHWAY AND PATIENT JOURNEY

  13. Action List • Business Case for Referral Coordinator • Business Case for additional GA Nurse • Developed new referral form • Developed new referral access criteria • Developed new referral management process • Developed new inpatient journey from ward to MRI • Worked with stakeholders to promote data input

  14. Referral Coordinator 4 week wait from referral to report Joined-up working between key stakeholders in patient journey Clear process & responsibilities defined for data management Current Landscape – Where are we now? Appropriate allocation of MRI duties & responsibilities Safe, sustainable, seamless patient journey to MRI and back 48 hours max wait for all urgent IP referrals Maximise MRI scanner utilisation Improve on current high quality of service to Referrers Improve MRI staff morale and job satisfaction Reduce DNA rates to < 4% and short notice cancellations Clear process & responsibilities for Managing referral pathway

  15. A&C Role Development Yorkhill’s MRI Service Lorraine Peebles, SIM, Diagnostics, NHSGGC 31 Mar 10

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