Quinte MRI free essay sample

The main concern of Kevin Saskiw and David Wright, BD coordinators at Quinte MRI, was addressed to ineffectiveness of the operation system at Quinte MRI. They were struggling to find the right solution for Chief Executive officer Dr. Syed Haider. Quinte MRI clinic in Belleville had 14 days patients’ waiting list for MRI scans. On other hand patients were experiencing frequent delays at the clinic due to poor communication between the patients and scheduling department. Due to the issues above, the Quinte MRI started to lose their clients as physicians started to refer their patients to competing MRI clinics. The systematic issues were identified as lack of overall organization understanding strategy, as well as lack of tools and system for proper communication. There was also lack of staff and unsystematic approach to manage the magnetic resonance imaging (MRI) facility at Benton-Cooper Medical Centre (BCMC) in Palmer. , NewYork. In order to solve the case, Saskiw and Wright had to examine the process flows for the patient, the technologists’ process for serving clients (patients and radiologists) and the transcription report. Once the new system is implemented this will ensure that Quinte MRI will meet the required efficiencies outlined by our client. This report will be used for discussion in our meeting with you tomorrow, June 14. Kevin Saskiw, David Wright Business Development Coordinators June 13, 2002 Immediate Issue Only six weeks into service, the MRI clinic is backlogged with a lead time of 14 days. The sole MR Technologist is working overtime just to keep up with the appointments. The clinic is not meeting the 2 day lead time and 2 scan per hour capacity that the hospital expects of them. This immediate issue is causing the secondary issues at the clinic which are listed below. Secondary Issues BCMC scheduling appointments: Hospital administration is currently scheduling all appointments for the MRI clinic. The hospital has never had this responsibility before, and they are not aware of how long each type of procedure takes. Having 24-hour availability, seven days a week is critical to the partnership with BCMC since we have agreed to meet capacity targets of two scans per hour. Working overtime: The only MR Technologist we have works 40 hours of overtime several weeks in a row to catch up with the appointments. The scheduling delays are on his shoulders because he is the only Technologist we have to see patients. He experiences frantic running around in order to get the procedures done that have been poorly scheduled. He is growing unhappy because he has limited time with his family. Idle time: Patients are booked at the wrong times and they are not being screened properly. Patients who shouldn’t receive an MRI are scheduled and then sent home causing idle time between appointments. Sometimes the scheduling department under-books for the day because personnel can’t read the schedule due to poor hand written notes. Angry patients: Patients are being scheduled for MRI’s when they are not needed. In addition, they are booked at the wrong times and get very angry when they are sent home because they took time off work. Management reaction: Monica Zimmerman, Manager of Radiology, is concerned that Sinclair is working too many hours. She is pressuring us to hire a second MR Technologist to take workload off of Sinclair and improve lead time. Analysis Qualitative Quinte MRI is a small but growing international service provider specializing in MRI services, among other medical technologies. We are seasoned in exclusive and partnership business arrangements with hospitals, physicians and individuals. We have adopted a culture of providing high-level health services to small communities to match those available in large urban areas. We offer impressive capabilities such as 24 hour service seven days per week which we consider to be our competitive advantage in this industry. Our people have always been committed to maintaining Quinte’s culture of integrity and personal attentiveness to the health services we provide. There is significant demand for MRI scans in the United States. The annual scan rate is approximately 68 per 1000 people. It is anticipated that the demand for MRI scans in Adelaide County will continue to grow at approximately 15 percent per year. In addition, the Cancer rate of Adelaide County is higher than the national average, making this partnership with BCMC a sustainable business decision for Quinte. At time of opening, turnkey operations were set up in the mobile clinic to service BCMC at full capacity. We leased and installed a 1.5-Tesla GE short-bore high-speed MRI system at the hospital’s request. The incentive of entering into this deal with BCMC was to hold 100% interest and be responsible for most of our operations and management. This was a strategic move since interest held in all of our other clinics is currently less than 20 percent. When we negotiated the contract with BCMC, we did not discuss training requirements and administration of training since we were responsible for the operations and management. We did not train the hospital’s Scheduling Department on our scanning scheduling requirements. This was a significant oversight on our part. Six weeks into servicing BCMC, we already have a waiting list of 14 days for MRI scans. BCMC is very unhappy that we are not living up to the capacity promises we made to them of scanning two patients per hour. They are complaining that they are losing patient referrals from doctors within the hospital and in the surrounding community. They are sending potential customers to the competition because we cannot provide timely scans, and this is lost revenue both Quinte and BCMC since we are direct partners. Quantitative In the last three weeks of business, the MR Technologist is scanning at an average of approximately 10 scans per day. This is the performance with an average of 9 hours of weekly overtime. According to our agreement with BCMC, this number should be 16 scans per day, and we should not require overtime based on what we know about our operations and time required for each procedure. Month Day Date # of Scans Hours Worked Overtime Hours Overtime Costs May Monday 20 10 9 1 $48 May Tuesday 21 12 11.5 3.5 $168 May Wednesday 22 11 10 2 $96 May Thursday 23 13 11 3 $144 May Friday 24 10 9.5 1.5 $72 May Saturday 25 0 0 0 $0 May Sunday 26 0 0 0 $0 TOTAL 56 51 11 $528 DAILY AVG 11.2 10.2 Month Day Date # of Scans Hours Worked Overtime Hours Overtime Costs May Monday 27 0 0 0 $0 May Tuesday 28 10 8 0 $0 May Wednesday 29 16 12 4 $192 May Thursday 30 7 6 0 $0 May Friday 31 10 12 4 $192 June Saturday 1 0 0 0 $0 June Sunday 2 0 0 0 $0 TOTAL 43 38 8 $384 DAILY AVG 10.75 9.5 Month Day Date # of Scans Hours Worked Overtime Hours Overtime Costs June Monday 3 0 0 0 $0 June Tuesday 4 7 7.5 0 $0 June Wednesday 5 12 12 4 $192 June Thursday 6 12 12 4 $192 June Friday 7 6 5.5 0 $0 June Saturday 8 0 0 0 $0 June Sunday 9 0 0 0 $0 TOTAL 37 37 8 $384 DAILY AVG 9.25 9.25 In the past 3 full weeks, we have incurred $1296.00 in overtime fees to pay Sinclair. A review of current operations allowed us to identify bottlenecks in the scanning and diagnostic processes in order to see where the problem operations exist. We have identified the 90 minute procedures in the Scanning Process, and film transfer to the Radiologist in the Diagnostic Process to be the bottleneck operations in this system. The Scanning Process Operation Minutes Bottleneck Operation? Customer contact MRI scheduling dept for appointment 5 Receptionist schedule appointment 1 On arrival, patient check in at Reception Desk 2 Patient wait in waiting room unknown MR Technologist escort new patient MR machine, ask health questions, check clothing acceptable for scan 5 Patient indicating health risks are sent home (1.2 per day) 1 Metal objects on clothes require change into hospital gown 4 Orientation of procedure in scan room and verify paperwork 1 MR Tech position the patient in the MR scanner 4 Perform MRI procedure: 30 min 16.5 45 min 24.75 60 min 33 90 min 49.5 MR Tech enters patient information into the hospitals system 1 MR Tech print MRI films (per patient) 6 MR Tech remove patient from scanner 4 MR Tech escort patient back to Reception Desk 2 Hospital gown requires change into street clothes 4 MR Tech check off procedure completion at Reception Desk 1 Radiologist read patient film and determine diagnosis 5 TOTAL MINUTES PER PATIENT 90.5 TOTAL HOURS PER PATIENT 1.5 The Diagnostic Process Operation Minutes Bottleneck Operation? MR Tech transfer film to Radiologist 360 Radiologist read and diagnose film 5 Radiologist transfer diagnosis to Transcription Department 1 Transcription Department types diagnosis 180 Radiologist approve typed transcription diagnosis 120 TOTAL MINUTES FOR DIAGNOSIS 666 TOTAL HOURS FOR DIAGNOSIS 11.1 Alternatives Short Term ST1 Do nothing. The clinic will continue to be backlogged and we will be unable to meet our promise of scanning two patients per hour. Our reputation with BCMC will be lost quickly as they will continue to refer patients to competing clinics. In addition, patients will continue to be angry if they are waiting past the appointment time scheduled. ST2 Hire part time MR Technologist and add partial second shift to help Jeff Sinclair. ST3 Hire full time MR Technologist to help Jeff Sinclair. ST4 Reclaim scheduling operation and stop paying the hospital $5.00 per scan for the service. The MRI clinic Receptionist will organize all scheduling. With the current scheduling setup, and we are not meeting our targets. The clinic has promised the hospital that we will scan two patients per hour and maintain an MRI lead time of two days so the scheduling function needs to be brought back under our control. ST5 Create standard Service Requisition Form mandatory for all patients. No appointments can be made without the standard form. Quinte would provide an electronic copy to hospitals, physicians and individuals requesting MRI services. In addition, we could set up a general email account for receipt of all requisition forms. Any client issuing a requisition form for services must submit electronically to [emailprotected], with the patients first and last name as the subject line. When the patient or hospital administrator contacts our Reception Desk to set up appointment, the receptionist can view the patients requisition form and schedule the proper procedure and time slot required. The following information would need to be on the requisition form: Procedure required Contact info and address of clinic Instructions and clothing restrictions for day of appointment ST6 Create standard questionnaire mandatory for patients to fill out in order to determine whether there are health conflicts preventing the MRI procedure. The patient would arrive 15 minutes prior to the scheduled appointment to fill out the questionnaire. The Receptionist would prepare the form with the patient’s file for the MR Technician to review when he is ready. The questionnaire would also include questions that help the patient determine whether they are wearing appropriate clothing and if they require changing into a hospital gown or not. ST7 Implement late fees and cancellation fees to encourage patient compliance to the schedule. Patients cannot reschedule a missed appointment without paying the incurred late fee. Late fees must be paid prior to the scheduled MRI. All fees to be stated clearly on patient requisition form so all patients are aware of them. If patients are on time and do not cancel appointments at the last minute, there will be less idle time on the MRI machine and less frantic running around trying to calm angry patients. Recommendation Implementation Plan # Description Type Horizon Responsibility Start End Status 1 Reclaim scheduling operation from hospital Strategic Short Term Dr. Syed Haider, Davis Wright, Kevin Saskiw June 14 June 27 Not Started 2 Create electronic schedule in Microsoft Excel Tactical Short Term Receptionist, MR Technologist June 14 June 16 Not Started