CLIMP Rapid Improvement Event 1: Improving the Scheduling & Vetting processes for CT, MRI & Ultrasound (Supported by Siemens Healthineers & Simpler Consulting) Background Over 150,000 CT, MRI & Ultrasound scans are performed every year by Radiology The project team worked with the CT, MRI & Ultrasound multidisciplinary teams to improve quality, safety, efficiency and patient experience from the point of referral to the time of receiving their appointment within the department. These teams, using Lean and Six Sigma tools worked together to identify issues, agree what they wanted to focus on, measured and analysed the current system, with a view to making improvements, and then put in place systems to implement and sustain the improvements. The work of the administrative and booking team was shadowed to gain a good understanding of the internal processes as outlined in the process maps: Improving referral processing time & reducing waiting times: The team have implemented a new back-office process whereby they no longer print emailed referrals and scan the documents onto the system instead they copy the details of the patient across to reduce the waste of paper and also increase efficiency in processing referrals in. The external referral form on the website was re-designed to improve the format and layout and uploaded onto the website to make it easier for GP’s to use and also easier for the administrative team to process the information provided. The team have re-launched the campaign to stop referrals being faxed through to the department. All GP surgeries have already been advised of this and the fax machine will be unplugged to encourage emails. The fax number has been removed from the GSTT website and updated with the email address to be used. The booking and vetting processes were analysed in considerable detail and a new internal system is being tested: instead of vetting referrals and then booking appointments, the decision was taken to reverse this & book patients before vetting. We will be collecting data to analyse the efficiency of this set-up. The project team worked together to deliver new ‘crib’ sheets to be used in the booking hub to enable immediate booking of patients onto the system and to provide clear guidelines for schedulers to follow. The radiologists have set-up electronic vetting groups to improve the speed and frequency of vetting appointments. This also included the development of ‘Referrer Crib sheets’ to assist with bookings. Overall, the RIE allowed the number of steps in the process to reduce from 69 to a much fewer 17. Improvements made during and following the Rapid Improvement Event Outcome objectives/ measures Reduce the delays for the patient by reducing the time before image acquisition Eliminate delays and backlog in vetting and scheduling meaning patients have an agreed appointment sooner Reduce/eliminate the duplication, rework and variation within the vetting and scheduling processes (touch time) Reduce the time from referral received to correct appointment scheduled (flow time) Improve the web-site and intranet pages Improve communication with patients via text and email Monitor the processes to measure efficiency Progressing ERS referrals in line with wider Trust initiatives Further sustained GP engagement with CLIMP Next steps Service Improvement Manager – Paulomi.Vyas@gstt.nhs.uk Programme Manager – Nick.Bultitude@gstt.nhs.uk