The Health Roundtable Project RED: Roll out of electronic ordering from ED to Radiology Presenter:...

The Health Roundtable

Project RED: Roll out of electronic ordering from ED to RadiologyPresenter: Jayne Morris

St Vincents Sydney

Innovation Poster SessionHRT1215 – Innovation AwardsSydney 11th and 12th Oct 2012


KEY PROBLEM

Time wasted for Emergency Department (ED) doctors walking to Radiology with a hand-written imaging request form and talking to Radiographers & Radiologists to request a CT scan

Interruptions to Radiologists in the middle of reporting on images

ED only department in the hospital not using electronic ordering for medical imaging

Paper order forms illegible and with missing information


AIM OF THIS INNOVATION

To streamline the processes of ordering of medical imaging for emergency department patients

Goal: For 90% of radiology requests from ED to be electronic within 8 weeks of going live


BASELINE DATA

Only 3% of radiology orders from ED were placed electronically in early 2012.

Time wasted: ED Doctor time: 5-10 minutes per request Radiographer: 5 minutes per request Radiologist: 5 minutes per request

Money wasted = $270,996 per year

Staff Time (h) CT orders per day

Non-clinically appropriate walkarounds (97%)* Days pay rate ($/h) Total cost ($)

Radiologist/Radiology Registrar 0.13 22 21 365 143 139,230Radiographer 0.08 22 21 365 68 44,138ED staff specialist/Registrar 0.08 22 21 365 135 87,627

270,996*3% of walkarounds were clinically appropriate


KEY CHANGES IMPLEMENTED

ED-Radiology Service Agreement Putting in place agreed business processes



Agreedbusinessprocesses



ED-Radiology Service Agreement Putting in place agreed business processes Education for all staff Implementation of electronic ordering Review of ED porter roles and responsibilities Simplification of the electronic request form –

some unnecessarily mandatory fields no longer necessary

Issues log Weekly multi-disciplinary team problem-solving

meetings


OUTCOMES SO FAR

Aim of our project was for 90% of radiology requests from ED to be electronic within 8 weeks of going live. This was ACHIEVED…AND EXCEEDED with 98% of orders electronic

Notional efficiency savings = $270 000 per year Improved quality with increased legibility of

orders and less missing information We now have data on ordering times so we can

break down the ordering process into “Triage to Order time” and “Order to Imaging time” for ongoing problem-solving and improvement of work


LESSONS LEARNT

Issues log to assist with problem solving Problem-solving meetings A multidisciplinary team brings different

perspectives, with each member able to solve different issues and communicate with other staff in their department

Information technology cannot be implemented in isolation –it is essential to work out the business processes to go with it

The Health Roundtable Project RED: Roll out of electronic ordering from ED to Radiology Presenter:...

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