Determine the Root Cause Activity: Determine the Root Cause In this activity, you will use the given information to determine the root cause of the problem. BEGIN

Y Reporting Process The time that the ou are the manager of a medical Order is placed. Radiologic technologist takes x-ray. Transcriptionist types up report. Radiologist approves and signs the typed report. Report is immediately faxed to the referring doctor’s office. imaging department. You have received several complaints from referring doctor’s offices that the turnaround time for radiology reports is too long. To determine the root cause, what will you consider? (Click on your answer below) The time that the x-ray was ordered and the time the report was faxed. The number of exams read by each radiologist. The number of reports typed up by each transcriptionist. GOOD WORST OK Start Over Exit

Good answer! Continue The time that the Since the problem is with turnaround time, it’s a good idea to find out the total time the process takes. The time that the x-ray was ordered and the time the report was faxed. YOU CHOSE: Continue

The number of reports typed up by each transcriptionist. Poor choice. The problem is not with the number of reports, so this data is not what you need to examine. The number of reports typed up by each transcriptionist. YOU CHOSE: Try Again

The number of exams read by each radiologist. Poor choice. The number of exams read has not been an issue. You must look elsewhere for data. The number of exams read by each radiologist. YOU CHOSE: Try Again

N ow that you have determined that the data you need to gather is time, you must figure out where to find the relevant information. To find the relevant information, what will you do next? (Click on your answer below) Ask the radiologic technologists, radiologists, and transcriptionists how long it takes to complete their respective tasks. Look at the computer logs to see at what time each step of the process was completed. Watch the process a few times to see how long it takes from start to finish. OK GOOD WORST Start Over Exit

Good answer! This will give you an accurate view of the time it takes to complete the process, and which parts of the process take the longest. Look at the computer logs to see at what time each step of the process was completed. YOU CHOSE: Continue

Poor choice. This will not give you an accurate idea of time because it is based on each person’s memory and opinions. It also will not give you specific information about previous cases. Ask the radiologic technologists, radiologists, and transcriptionists how long it takes to complete their respective tasks. YOU CHOSE: Try Again

This will take up a lot of your time Poor choice. This will take up a lot of your time and won’t give you good data because you can only follow a few orders to completion at a time. It also won’t give you information about previous cases. Watch the process a few times to see how long it takes from start to finish. YOU CHOSE: Try Again

T Your findings: o determine which part of the process is causing the delay, you randomly select 100 radiology exams that have already been completed. For each one, you look up the time ordered and the time the x-ray was performed. Your standard is one hour. 80% of x-rays were performed within one hour of the order being placed 15% were performed within two hours 5% were performed within three hours Based on your findings, what do you decide? (Click on your answer below) The 1-hour time limit is the root cause of the problem and x-rays should be taken sooner. You set a new standard of 30 minutes. The time between the order and the x-ray is not the root cause. You need to look at other parts of the process. The 1-hour time limit is the root cause and more time should be allowed for x-rays. You set a new standard of 2 hours. WORST GOOD OK Start Over Exit

Good answer! Most of the x-rays are being taken within the time limit. This isn’t where the delay is occurring, so you should look at other steps in the process. The time between the order and the x-ray is not the root cause. You need to look at other parts of the process. YOU CHOSE: Continue

Poor choice. X-rays are taken within the new time limit, but you get even more complaints because now the process is taking even longer to complete. The 1-hour time limit is the root cause and more time should be allowed for x-rays. You set a new standard of 2 hours. YOU CHOSE: Try Again

Poor choice. The technologists are unable to complete x-rays within that limit. They begin to complain, and you continue to receive complaints about the overall turnaround time. The 1-hour time limit is the root cause of the problem and x-rays should be taken sooner. You set a new standard of 30 minutes. YOU CHOSE: Try Again

H Your findings: aving decided to examine the entire process, you then look at how much time each step takes—from the order being placed until the time the completed report is sent. The biggest lag occurs between the x-ray being taken and the radiologist reading it. The next biggest lag is between the time the radiologist reads the x-ray and the transcriptionist types it. Based on your findings, what do you decide? (Click on your answer below) Fire the slowest radiologist and transcriptionist. Change the schedule so transcriptionists and radiologists work slightly longer hours and more are available at any given time. Hire another transcriptionist and modify the radiologists’ schedules so another one is available during busy times. WORST OK GOOD Start Over Exit

You found the root cause! As a result of your decisions, turnaround time decreases justifying the added expense of another transcriptionist. You still have some issues related to staff members who don’t work as quickly, but the overall situation has improved. Hire another transcriptionist and modify the radiologists’ schedules so another one is available during busy times. YOU CHOSE: Continue

Poor choice. Turnaround time decreases slightly, but transcriptionists and radiologists complain about the longer work hours and you fear some of them may quit. Change the schedule so transcriptionists and radiologists work slightly longer hours and more are available at any given time. YOU CHOSE: Try Again

Poor choice. Having fewer staff members has made the turnaround time even longer and the remaining radiologists and transcriptionists complain about the extra work. Fire the slowest radiologist and transcriptionist. YOU CHOSE: Try Again

problems root The End Determining the root of a problem is an investigative process. Finding a solution will only work if the root cause is identified properly. Make sure to look at the entire picture. Start Over