Imaging Technology News - January/February 2009 - (Page 31) Business Focus RADIOLOGY BUSINESS Reduce Waste to Raise Revenue A radiation oncology center eliminates waste to boost productivity and quality of care. By Cristen C. Bolan ThedaCare redesigned its processes before adopting radiosurgery and installing a Cyberknife System by Accuray. olicy makers talk about improving the healthcare system by cutting costs. But all too often, as we have seen recently with the Deficit Reduction Act of 2005, this approach comprises patient access to care. However, cutting costs and improving quality do not have to be mutually exclusive. A more effective strategy is to look at how patient care can be improved without increasing spending. Sound too good to be true? For the radiation oncology department at ThedaCare, a Wisconsin-based health network, it became a reality. After implementing ‘lean management’ techniques, the department in one year alone, improved productivity by 30 percent, increased gross revenue by 24 percent and reduced the time from patient referral to treatment by 44 percent. P The Patient’s Take To determine the value of their patients’ experiences, the department surveyed patients about their treatment. ThedaCare determined that patients found the most value in the face-to-face interactions with hospital staff. The radiation oncology department quickly went to work, and started a series of rapid improvement events that would help physicians, nurses and staff eliminate the waste in their daily tasks and allow patients more face-to-face interactions. an MRI, we schedule that too. After the sims and the MRI, we have the physician huddle with the radiation therapist, the dosimetrist and the physicist to look at the scans to make sure they are accurate before the patient leaves so that we don’t have to redo the simulation or the MRI. This allows us to get the patient more quickly to treatment, improve quality and reduce costs because there are no duplications or replanning.” Today, ThedaCare has reduced the process to eight days, and the procedure volume has increased. “Our procedures are up 40 percent,” noted Barnas. “In addition to lean management, we are discovering that some of the patients previously treated on the Varian or TomoTherapy can get boosted by Cyberknife. Although our volume is up, our treatment is up at a much more significant rate.” Once the lean management strategy was in full swing at ThedaCare, the physicians saw improvements from a quality care perspective, the administration saw the cost reduction benefit and fortunately the patients have been able to see the greatest benefits. ITN Prepping for New Technology Thedacare applied lean management practices before installing a Cyberknife radiosurgery system, which represented technology that was new to the facility. To do this, they focused on one thing — the patient and eliminating waste. Physician Buy-In With the guidance of Simpler Healthcare, a consulting group, ThedaCare adopted lean management principles — a methodology, originally developed at Toyota in its Toyota Product System, which trains employees to identify and eliminate waste, thus improving patient care and cutting cost. Thedacare set out to implement lean management first by getting the hospital staff to identify the value stream of the department. This involved analyzing the whole care cycle, from check in at reception, to receiving treatment, to getting test results; each step in the patient’s experience was evaluated to determine if it added value to the process. “Then we looked at the steps that do not produce value – waiting, misdiagnosis, motion transportation – anything that falls under the category of waste. Then we focused on the nonvalue add – in this case the things the patients have to do, but doesn’t provide better care,” said Simpler Healthcare’s General Manager Mike Chamberlain. What is key to the success of implementing lean management in healthcare is physician buy-in. One of the breakthrough improvement events was aimed at helping physicians understand their capacity as far as their schedule is concerned. To help overburdened physicians, the radiation oncology department developed a team approach in which patients were able to receive more face time with hospital staff and physicians received the necessary support to keep on task with their schedule. The idea is to improve quality, capacity, staff and patient satisfaction, while reducing cost. —Mike Chamberlain Simpler Healthcare “Rather than hiring two radiation therapists, another physicist, another dosimetrist, we looked at ways to reduce waste in other processes that would create the capacity to take on this new technology without additional cost,” said Kim Barnas, vice president of the radiation oncology department. “Where we thought we were going to have to hire four FTEs we were able to only hire two.” ad index COMPANY WEB ADDRESS Bayer HealthCare Pharmaceuticals Inc. imaging.bayerhealthcare.com Candelis www.candelis.com GE Healthcare www.gehealthcare.com National Consortium of Breast Centers Inc. www.breastcare.org Invivo www.invivocorp.com Philips www.philips.com/pacs Sapheneia www.claritysolutions.org SenoRx Inc. www.senorx.com Siemens Medical Solutions www.usa.siemens.com/healthcare PAGE 5-6 32 13 8 29 12 23 27 16 Reduced Treatment Times Another strategy for eliminating waste was to reduce treatment time. “We had a goal of reducing our treatment time, which three years ago was 23 days from first consult to first treatment, by 50 percent each year. In doing that you have to look at all of the components of the process,” said Barnas. “The initial phase begins when a patient comes in for a consult - we do the sim, then the MRI. The dosimetrists get their first plan to the physician and changes are made, and we schedule the first treatment,” said Barnas. “By reducing the time from three days to one day, we improved quality.” The process today is much more streamlined. As Barnas explained, “Now if there needs to be ITNonline.net | Jan/Feb 2009 | ITN | 31 http://imaging.bayerhealthcare.com http://www.candelis.com http://www.gehealthcare.com http://www.breastcare.org http://www.invivocorp.com http://www.philips.com/pacs http://www.claritysolutions.org http://www.senorx.com http://www.usa.siemens.com/healthcare http://www.ITNonline.net
Table of Contents Feed for the Digital Edition of Imaging Technology News - January/February 2009 Imaging Technology News - January/February 2009 Contents IMRT Imaging RT Solutions for Troublesome Tumors PACS Radiology to Close the Imaging Loop Will Web-Based PACS Take Over? Is CT Dose Under Control? The Best in Digital Mammography Breast Biopsy Systems MX Series Monitors Provide University of Pennsylvania Quality Assurance Reduce Waste to Raise Revenue Imaging Technology News - January/February 2009 Imaging Technology News - January/February 2009 - Imaging Technology News - January/February 2009 (Page 1) Imaging Technology News - January/February 2009 - Contents (Page 2) Imaging Technology News - January/February 2009 - Contents (Page 3) Imaging Technology News - January/February 2009 - IMRT (Page 4) Imaging Technology News - January/February 2009 - IMRT (Page 5) Imaging Technology News - January/February 2009 - Imaging (Page 6) Imaging Technology News - January/February 2009 - RT Solutions for Troublesome Tumors (Page 7) Imaging Technology News - January/February 2009 - RT Solutions for Troublesome Tumors (Page 8) Imaging Technology News - January/February 2009 - PACS (Page 9) Imaging Technology News - January/February 2009 - PACS (Page 10) Imaging Technology News - January/February 2009 - PACS (Page 11) Imaging Technology News - January/February 2009 - PACS (Page 12) Imaging Technology News - January/February 2009 - PACS (Page 13) Imaging Technology News - January/February 2009 - PACS (Page 16) Imaging Technology News - January/February 2009 - Radiology to Close the Imaging Loop (Page 17) Imaging Technology News - January/February 2009 - Will Web-Based PACS Take Over? (Page 18) Imaging Technology News - January/February 2009 - Will Web-Based PACS Take Over? (Page 19) Imaging Technology News - January/February 2009 - Will Web-Based PACS Take Over? (Page 20) Imaging Technology News - January/February 2009 - Will Web-Based PACS Take Over? (Page 21) Imaging Technology News - January/February 2009 - Is CT Dose Under Control? (Page 22) Imaging Technology News - January/February 2009 - Is CT Dose Under Control? (Page 23) Imaging Technology News - January/February 2009 - The Best in Digital Mammography (Page 24) Imaging Technology News - January/February 2009 - Breast Biopsy Systems (Page 25) Imaging Technology News - January/February 2009 - Breast Biopsy Systems (Page 26) Imaging Technology News - January/February 2009 - Breast Biopsy Systems (Page 27) Imaging Technology News - January/February 2009 - Breast Biopsy Systems (Page 28) Imaging Technology News - January/February 2009 - Breast Biopsy Systems (Page 29) Imaging Technology News - January/February 2009 - MX Series Monitors Provide University of Pennsylvania Quality Assurance (Page 30) Imaging Technology News - January/February 2009 - Reduce Waste to Raise Revenue (Page 31) Imaging Technology News - January/February 2009 - Reduce Waste to Raise Revenue (Page 32)
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