Improvement Advisor, Ko Awatea, Counties Manukau District Health Board, Auckland.
Portfolio Manager, Ko Awatea, Counties Manukau District Health Board, Auckland.
N Z Med J. 2021 Jun 25;134(1537):27-35.
A capacity and demand improvement initiative commenced in January 2019 with the goal of reducing the growing outpatient waiting list for magnetic resonance imaging (MRI) at Counties Manukau District Health Board (CMDHB). Initial work showed that the capacity (MRI machines and staff) actually outstripped demand, which challenged pre-existing assumptions. This became the basis for interventions to improve efficiency in the department. Interventions undertaken can be split into three distinct categories: (1) matching capacity to demand, (2) waiting list segmentation and (3) redesigning operational systems.
A capacity and demand time series during 2019 and 2020 was used as the basis for improving waiting list and operational systems. A combination of the Model for Improvement and Lean principles were used to embed operational improvements. Multiple small tests of change were implemented to various aspects of the MRI waiting list process. Staff engagement was central to the success of the quality improvement (QI) initiatives. The radiological information system (RIS) provided the bulk of the data, and this was supplemented with manual data collection.
The number of people waiting for an MRI scan decreased from 1,954 at the start of the project to 413 at its conclusion-an overall reduction of 75%. Moreover, the average waiting time reduced from 96.4 days to 23.1. Achieving the Ministry of Health's (MoH) Priority 2 (P2) target increased from 23% to 87.5%.
A partnership between Ko Awatea and the radiology department at CMDHB, examining capacity and demand for MRI and using multiple QI techniques, successfully and sustainably reduced the MRI waiting list over a two-year period. The innovative solutions to match capacity to demand may be instructive for other radiology departments, and other waiting list scenarios.
2019 年 1 月启动了一项能力和需求改善计划，旨在减少 Counties Manukau District Health Board（CMDHB）磁共振成像（MRI）门诊等候名单的不断增长。初步工作表明，MRI 机器和员工的实际能力超过了需求，这挑战了先前的假设。这成为该部门提高效率的干预措施的基础。所采取的干预措施可以分为三个不同类别：（1）使能力与需求相匹配，（2）对等候名单进行细分，（3）重新设计运营系统。
2019 年和 2020 年的能力和需求时间序列被用作改善等候名单和运营系统的基础。改进模型和精益原则的结合被用于嵌入运营改进。对 MRI 等候名单流程的各个方面进行了多次小的变更测试。员工参与是质量改进（QI）计划成功的关键。放射信息系统（RIS）提供了大部分数据，并辅以手动数据收集。
接受 MRI 扫描的人数从项目开始时的 1954 人减少到项目结束时的 413 人，总体减少了 75%。此外，平均等待时间从 96.4 天减少到 23.1 天。达到卫生部（MoH）优先级 2（P2）目标的比例从 23%增加到 87.5%。
Ko Awatea 与 CMDHB 的放射科合作，检查 MRI 的能力和需求，并使用多种 QI 技术，成功且可持续地在两年内减少了 MRI 等候名单。匹配能力与需求的创新解决方案可能对其他放射科和其他等候名单情况具有启示意义。
