Radiology best practice: Extracting value and improving operational efficiencies in a large health system

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Spectrum Health Placard Team Photo2.jpg - Spectrum Health Placard Team
The placard project was proposed and initiated by Vallillee, then largely driven by teams whose input was mainly intellectual collateral, drawn from daily workflows, and drawn from the radiology IT system used throughout Spectrum.

The continuity of business is vital in any setting but even more so in hospitals when patient encounters and care delivery may be interrupted. Considering the importance of the work that is carried out in healthcare facilities, developing continuity of business plans at all points of patient care is completely essential.  Setting an example for other facilities, Spectrum Health System in West Michigan has developed a unique methodology to improve the fidelity of the patient experience in radiology during a planned system downtime or system disruption. Continuity of business in a facility as large as Spectrum Health requires thoughtful planning, setup, reaction, and follow through to ensure everything runs as according to plan.  George Vallillee, manager of Radiology Information Solutions at Spectrum Health, shares the details of his approach, plan and resulting improvements in Spectrum radiology’s operational efficiencies.

George Vallillee, Manager, Radiology Information Solutions, Spectrum Health

Value equation

Value in radiology can be measured on many different levels from absolute cost, to quality of service, to accuracy of diagnosis and treatment plans. Because the healthcare environment has changed so dramatically, brought about by the need to mitigate the consistently increasing costs of healthcare, it’s vitally important to seek out new avenues to improve the patient experience.

“What we were trying to do at Spectrum,” explains Vallillee, “was look at how we can accomplish ever increasing levels of value without going into the six-figure investment cycle that radiology has become accustomed to. How can we improve the stability of the patient encounter using lean processes and new techniques?”

Radiology at Spectrum Health is a complex system of people, processes and technology working like a well-oiled machine. With a radiology staff consisting of 900 people, most of whom are technologists, Spectrum Health Radiology serves its communities with 11 hospitals and 170 ambulatory and service sites and operates the only Level 1 Trauma Center in West Michigan.

“Over a 24x7 cycle, we run extremely well, like an engine, but when we’re looking at improving the paradigm of enhanced care and better value to the customer, we asked the question, ’What do we do when one of our engine cylinders fails?’” asks Vallillee.

In the case of radiology being highly technology driven, Vallillee and team looked at the technology component and considered the business continuity plan for when a core piece of technology, such as EMR or PACS, is unavailable.

Documented strategies

If you’re a pilot and there’s an engine fire in the right engine of your plane, what do you do next? Will you and your crew know how to operate when your traditional workflow is out the window? Pilots use a well-documented system of checklists configured to each particular type of aircraft and covering most every detail that occurs on a flight. The steps are well-thought out in advance by the engineers who built the plane, and by the safety experts who know it best. Why couldn’t the same concept be used in radiology?

“As complex as our systems are, we didn’t have anything similar,” says Vallillee. “I turned to the pilot training I experienced earlier in my life to come up with the idea for a similar series of checklists to follow in situations of system downtime or failure in our radiology department.”

“The placards do a great job of outlining what each individual should do during a system interruption," says Vallillee.

The new project was proposed by Vallillee and initiated soon thereafter. It was largely driven by teams whose input was mainly intellectual collateral, drawn from daily workflows, and drawn from the radiology and IT system used throughout Spectrum. Key roles within the department were identified, and detailed workflows were documented. There are eight key roles identified during the discovery process. These individuals either work within the radiology department, or interact with the radiology department. Each role has its own set of placards for reference, and the placards are located at clearly marked places within the hospital system. Each set of placards contains tabs to identify the different critical systems that may be malfunctioning, such as the EMR, PACS or the hospital’s network. Individuals that represent each specific role can use the set of placards to reference detailed instructions on how to maintain operations for their function under