Reducing imaging waiting times: enhanced roles and service‐redesign

Author:

Greaves Claire,Gilmore Judy,Bernhardt Lizelle,Ross Lisa

Abstract

PurposeThe aim of this paper is to explain how University Hospitals of Leicester's Nuclear Medicine service managers needed to reduce waiting times to comply with internal clinical requirements and with external local primary care trust (PCT) and national Department of Health targets.Design/methodology/approachThe team undertook a comprehensive service review to identify problem areas and potential improvements, including: process mapping; data gathering (activity and demand, equipment and staff availability/utilisation); external practice reviews, searching evidence bases; and financial implications. This case study describes how an inter‐disciplinary team redesigned the service and used new working methods to reduce waiting times. Their aim was to discuss a service's practical elements and show how innovation leading to sustainable change can be implemented effectively.FindingsThe review highlighted service delivery bottlenecks for myocardial perfusion imaging, which were linked to medical staff shortages, staff use and equipment between hospital sites, and a silo approach to referrals rather than a coordinated organisation‐wide approach.Practical implicationsIntroducing enhanced roles allowed nurses, radiographers and technologists to undertake work previously performed by medical staff thus removing a key service bottleneck. Modifications to service delivery and a cultural change in nuclear medicine resulted in a service that was more efficient, flexible and able to cope with increased demand.Originality/valueThese changes meant that minimum waiting‐time targets were achieved, in particular waiting for myocardial perfusion imaging (reduced from 42 weeks in 2005 to two weeks by 2009). Changes allowed service managers to maintain short waiting times in the current, challenging healthcare climate.

Publisher

Emerald

Subject

Health Policy,General Business, Management and Accounting

Reference6 articles.

1. Department of Health (2004), The NHS Improvement Plan: Putting People at the Heart of Public Services, The Stationery Office, London.

2. Jones, I., Latus, K., Bartle, L., Gardner, M. and Parkin, V. (2007), “Clinical competence in myocardial perfusion scintigraphic stress testing: general training guidelines and assessment”, Nuclear Medicine Communications, Vol. 28 No. 7, pp. 575‐82.

3. National Health Service (n.d.), “18 weeks, delivering the 18 week patient pathway”, available at: www.18weeks.nhs.uk/Content.aspx?path=/achieve‐and‐sustain/Diagnostics/Imaging (accessed 27 May 2010).

4. National Institute for Health and Clinical Excellence (2003), “Myocardial perfusion scintigraphy for the diagnosis and management of angina and myocardial infarction (TA73)”, available at: www.nice.org.uk/TA073 (accessed June 2011).

5. NHS Institute for Innovation and Improvement (n.d.), “How UHL reduced waiting times from 42 to two weeks”, available at: www.institute.nhs.uk/images/documents/How%20UHL%20Reduced%20Waiting%20Times.pdf (accessed May 2010).

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