Radiation Oncology Report (Turn-Around Time) Committee Members: Najeeb Mohideen, MD Autis Speights, Manager Radiation Oncology Preston Bricker, Sr. Systems.

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Presentation transcript:

Radiation Oncology Report (Turn-Around Time) Committee Members: Najeeb Mohideen, MD Autis Speights, Manager Radiation Oncology Preston Bricker, Sr. Systems Analyst Patricia Lenkart, Transcriptionist

Opportunity Statement and Desired Outcome  Report turnaround time for reports was approximately 4 weeks,causing a problem with reports not being available when patients returned for follow-up visits in Radiation Oncology.  Our goal is to ensure that all dictated medical documents are transcribed and distributed in a timely manner inter- departmentally as well as externally.

Most Likely Causes for Current Opportunity  Transcription staff and faculty were located at different facilities. (Dictation tapes were transported via courier)  Computer System: Antiquated (No ability to share information electronically)  Workflow based on delivery date of tapes (Not date of service)  Staffing level not sufficient: (Ratio of transcription to physicians was 1 to 9)

Solutions Implemented  Initial backlog of dictation was outsourced while team was working on a more streamlined process.  Transcription relocated closer to physician offices.  Tape submission/courier pick-up deadlines were reengineered to accommodate physician routine.  Reduced number of drop off locations for physicians.  Physician work room and transcription mail box.  Increased number of courier Loyola Clinic. Work flow based on date of service.  Monitored date of service and delivery time. ROIS system was purchased and installed.  Radiation Oncology Information System (IMPAC) Staffing level was adjusted  Decreased transcription to physician ratio, 1 to 4

Progress to Date Original Process Process Improvement Step #1: Physician dictates initial consult Physician dictates initial consult (Loyola Clinic) Loyola Clinic/Cancer Center Step #2: Places dictated tape in courier location Physician deliver tapes to transcription (Loyola Clinic) McGuire Bldg Step #3: Transport to Hines V.A. clinic Hines dictation transported from Hines One a.m. / One p.m. pick-up and drop off clinic to transcription Loyola. Step #4: Transcription pick-up tapes Dictation tapes transcribed by service date Multiple locations Step #5: Transcribed by delivery date Documents available in IMPAC First in First out Step #6: Documents transported back to Loyola Electronic physician approval Physician correction and approval Result: 4 or more weeks to final approval Result: More efficient process and patient chart

Results and Analysis BeforeAfter Before and After Intervention Report Availability and Distribution (following ROIS implementation) DeliveryTranscriptionApproval

Conclusions  Change to date of service workflow reduced overall TAT.  days to 10 days Streamlining key points in processes helped to further reduce TAT.  10 days to average of 5-7 days Implementation of ROIS system (IMPAC) allowed us to reach our goal of complete transcribed documents within 24 hours of the date of service and filed in patient record within 5-7 days.  On-line viewing/edits of documents  Electronic approval and signature  On line access to completed documents by clerical staff

Next Steps  Make Radiation Oncology documents available to other physician groups through utilization of electronic medical record. Refine existing processes so that electronic and paperless environment can be fully implemented. Continue to improve TAT at Hines V.A. clinic.