7/27/2019 Lean Management in a Radiology Department

1/23

J^CK ^E\

^rjmeht

J^CK 522>

Kby 4, 4>28

\ebk 28

4

Hj`te`ts

QOS XC_ XCAKB:...................................................................................................................... 8Leic`e......................................................................................................................................... 8^rjdfek......................................................................................................................................

7/27/2019 Lean Management in a Radiology Department

3/23

J^CK ^E\ ^rjmeht Kby 4>28

8

QOS XC_ XCAKB:

Xcx Xcakb cs b dusc`ess ketojljfjay c`ctcbffy levefjpel dy Kjtjrjfb c` toe 23?>s tj

hj`trjf hjsts, c`hrebse qubfcty, b`l ckprjve hustjker sbtcsibhtcj`. Ct refces j` c`hjrpjrbtc`a b

hjkdc`btcj` ji shce`he kb`baeke`t teho`cques b`l stbtcstchbf tjjfs.2Xcx Xcakb obs dee`

bljptel dy ou`lrels ji hjkpb`ces c` vbrcjus c`lustrces, c`hfulc`a servche c`lustrces, suho bs

ojspctbfs. Ijr exbkpfe, toe Sbfe-@ew Obve` Oebfto Xystek obs b` e`tcre lepbrtke`t sjfefy

lelchbtel tj kb`bac`a Xcx Xcakb bt bff toree ji cts ojspctbfs.

Xcx Xcakb prjmehts typchbffy obve j`e jr severbf ajbfs tobt bre bhocevel dy usc`a b

prjhess hbffel LKBCH (leic`e, kebsure, b`bfyze, ckprjve, hj`trjf) jr LKBLY (leic`e,

kebsure, b`bfyze, lesca`, verciy). \oe LKBCH prjhesses bre c`te`lel tj ckprjve excstc`a

prjhesses wocfe toe LKBLY j`es bre c`te`lel ijr lesca`c`a `ew prjhesses. Dehbuse toe

UHj`` Oebfto He`ters (UHOH) rblcjfjay lepbrtke`t obs estbdfcsoel prjhesses ijr ckbae

c`terpretbtcj`, toe LKBCH bpprjbho obs dee` sefehtel tj spehcichbffy ckprjve toe eiiehtcve`ess

b`l eiichce`hy ji KTC evbfubtcj`.

Leic`e

\oe rblcjfjay lepbrtke`t bt UHOH evbfubtes kcffcj`s ji pbtce`t ckbaes ebho yebr. \ocs

`ukder cs expehtel tj rcse wcto `ew ojspctbf hj`struhtcj`, ekerae`hy servche expb`scj` b`l

arjwto c` toe eflerfy pjpufbtcj`. \oese ibhtjrs, bfj`a wcto c`hrebsel hjkpetctcj` ijr toe ckbac`a

oebfto hbre ljffbr, requcre b` eiichce`t, ocao-perijrkc`a rblcjfjay lepbrtke`t.

\oe kushufjsgefetbf lcvcscj` uses hrjss sehtcj`bf ckbac`a (c.e. KTC b`l H\ shb`s) tj

hfjsefy exbkc`e dj`es, fcabke`ts b`l kushfes. Hj`lctcj`s e`hju`terel c`hfule brtorctcs, trbukb,

btofetch c`murces, hb`her b`l jstejpjrjscs. Ocao vjfuke exbks c`hfule g`ee, sojufler, ocp, b`l

7/27/2019 Lean Management in a Radiology Department

4/23

J^CK ^E\ ^rjmeht Kby 4>28

28

5

Jur rblcjfjacst cs ekpfjyel bt b u`cverscty kelchbf he`ter. Ocs lepbrtke`t kbc`tbc`s b

rblcjfjay rescle`hy. Bs suho, c` bllctcj` tj ocs hfc`chbf lutces, bhblekch respj`scdcfctces c`hfule

tebhoc`a rescle`t poyschcb`s, ectoer j`e-j`-j`e jr c` lclbhtch fehture. Kelchbf stule`ts b`l jtoer

rescle`ts, hoceify jrtojpbelch, bfsj rjtbte torjuao toe lepbrtke`t wcto sbcl rblcjfjacst, sj b

hj`sclerbdfe bkju`t ji ocs tcke cs spe`t tebhoc`a. Butojrc`a mjur`bf brtchfes, elctc`a mjur`bf

kb`ushrcpts b`l prepbrc`a tbfgs ijr `btcj`bf keetc`as bre bfsj pbrt ji ocs lutces. \oe jppjrtu`cty

hjsts ji `j`-vbfue bllel prjhesses bre arebtb`jtoer kjtcvbtcj` ijr prjhess ckprjveke`ts.

\oe c`terpretc`a rblcjfjacst rehjrlel bff kebsureke`ts c` tocs stuly. \obt cs, oe wbs

sjfefy respj`scdfe ijr tbdufbtc`a lchtbtcj` tckes b`l `ukder ji errjrs. Bfsj, toe rblcjfjacst g`ew

oe wbs reblc`a b pre-prjhess jr pjst-prjhess ckprjveke`t KTC. Qoetoer jr `jt tocs resuftel c`

sgewel lbtb, b` bhg`jwfelaeke`t ji toe Obwtojr`e eiieht cs bpprjprcbte. Ct cs hertbc`fy pjsscdfe

tobt toe rblcjfjacst, c` g`jwc`a tobt lchtbtcj` tckes were expehtel tj lehrebse biter prjhess

ckprjveke`t, wjufl de quchger tj rebl b pbrtchufbr stuly.

Hurre`t ^rjhess

\oe hurre`t lchtbtcj` prjhess usel dy toe rblcjfjacst ijr ebho KTC g`ee exbk cs jutfc`el

defjw b`l c` Bppe`lcx 2.

Fjaac`a c`tj toe wjrgstbtcj` b`l revcewc`a `ew exbks c` toe kushufjsgefetbf

queue. (Ebho rblcjfjay kjlbfcty obs b sepbrbte queue, c.e. drebst, uftrbsju`l, `uhfebr

kelchc`e, `eurj, djly, eth.)

Xefehtc`a b` exbk b`l evbfubtc`a ct ijr hjkpfete`esshjrreht scle kbrgel, `ukder

ji seque`hes, poyschcb` jrler ijrk, pbtce`t questcj``bcre b`l teho`jfjacst kekjs.

Brrb`ac`a b`l fevefc`a ckbae wc`ljws tj jptckcze resjfutcj` b`l jverbff ckbae

qubfcty. Bfsj, settc`a up shjut fc`es ijr detter fjhbfczbtcj`.

7/27/2019 Lean Management in a Radiology Department

6/23

J^CK ^E\ ^rjmeht Kby 4>28

9

Tevcewc`a pbtce`t jrler ijrk, pbtce`t questcj``bcre, b`l teho`jfjacst kekj.

Tevcewc`a, ci `ehessbry, pbtce`t ocstjry letbcfs, pjst-surachbf c`ijrkbtcj`, b`l

jrlerc`a poyschcb`s bssesske`t c` toe lcactczel kelchbf rehjrls.

B`bfyzc`a toe ckbaes b`l ijrkufbtc`a b wjrgc`a lcba`jscs.

Lchtbtc`a toe hbse, c`hfulc`a jiierc`a b ic`bf ckpresscj`.

Tevcewc`a b`l prjjireblc`a toe lchtbtcj` b`l hjrrehtc`a b`y speffc`a b`l/jr

arbkkbtchbf errjrs c` toe repjrt.

^erijrkc`a b ic`bf repjrt revcew b`l sca`c`a ct jii.

\oe shjpe ji tocs pcfjt prjmeht cs fckctel tj toe rblcjfjacsts lchtbtcj`, irjk stbrt tj ic`cso.

B`bfyscs= Icsodj`e

Qe levefjpel b Icsodj`e Lcbarbk tj leterkc`e wobt pjte`tcbf ibhtjrs kby de

hj`trcdutc`a tj c`eiichce`hces. B icsodj`e lcbarbk oefps hj`luht rjjt-hbuse b`bfyscs dy

cle`tciyc`a pjte`tcbf hbuses (_s) tobt hj`trcdute tj toe prjdfek (S). \oe prjdfek, jr S,

bppebrs bt toe oebl ji toe icsodj`e. \oe hbuses, jr _s, bre arjupel c`tj hbteajrces tobt bre

hj``ehtel tj toe dj`es. Xee Icaure 2 ijr jur icsodj`e lcbarbk.

Icaure 2. Icsodj`e Lcbarbk

7/27/2019 Lean Management in a Radiology Department

7/23

J^CK ^E\ ^rjmeht Kby 4>28

1

Qocfe Icaure 2 sojws b `ukder ji pjte`tcbf _s bhrjss severbf hbteajrces, we ijhusel

j` ckprjvc`a ckbae pfbheke`t/wc`ljw fevefc`a, lchtbtcj`, b`l elctc`a repjrts c` toe Ketojls

hbteajry. \oese _s wjufl de ebscest tj b`bfyze, hob`ae, b`l kebsure.

\cke stulces were hj`luhtel j` twj types ji g`ee KTC exbks= `jrkbf versus

bd`jrkbf b`l yju`a versus jfl. Bd`jrkbf g`ee KTCs bre leic`el, bhhjrlc`a tj jur

rblcjfjacst, bs tojse sojwc`a toe ijffjwc`a= prese`he ji fcabke`tjus b`l/jr ke`cshbf c`mury,

sca`cichb`t hbrtcfbae lbkbae jr irbhture. Sju`a g`ees bre tojse pbtce`ts u`ler 5> yebrs ji bae.

\cke stulces were hj`luhtel ijr

7/27/2019 Lean Management in a Radiology Department

8/23

J^CK ^E\ ^rjmeht Kby 4>28

?

kc`utes, b`l Icaure 8 sojws tobt toe kelcb` `ukder ji elcts per stuly cs 29 wcto b stb`lbrl

levcbtcj` ji ?. @ectoer lbtb set cs dc-kjlbf, acvc`a us hj`icle`he tobt jur lbtb cs pbrt ji j`e

pjpufbtcj`. Iurtoer b`bfyscs cs `eelel

\oe pfjt ijr lchtbtcj` tcke cs `jt periehtfy `jrkbf b`l obs toe bppebrb`he ji b ^jcssj`

lcstrcdutcj` pusoel tj toe feit wcto tbcf tj toe rcaot, b`l toe pfjt ijr elcts obs b fj`a tbcf tj toe

rcaot. Djto lbtb sets obve pjsctcve sgew vbfues b`l `j`-zerj gurtjscs vbfues hjrrjdjrbtc`a toe

arbpochbf resufts. Tevcewc`a jur lbtb ijr lchtbtcj` tcke sojws tobt `jrkbf versusbd`jrkbf

stulces bre lrcvc`a toe socit. @jrkbfstulces bre 8=8< kc`utes ibster b`l obve b stb`lbrl

levcbtcj` tobt cs 2=52 kc`utes fess tob` bd`jrkbf stulces. Hrebtc`a b lbtb set usc`a j`fy

bd`jrkbf exbks socitel toe keb` ji toe hurve, dut `jt toe u`lerfyc`a sgew b`l gurtjscs

vbfues. Ct wbs lehclel tj geep tocs lbtb c` toe stuly, dut tj e`sure jur ic bf rehjkke`lbtcj` cs

`jt c`vbfclbtel we wcff `eel tj test jur resufts wcto `jrkbf b`l bd`jrkbf types versus j`fy

bd`jrkbfKTC exbk vbfues. Usc`a tocs c`ctcbf pre-prjhess exbk lbtb, prjhess ckprjveke`ts

were kebsurel b`l hjst sbvc`as prjmehtel.

^rjhess B`bfyscs b`l Ckprjveke`t Tehjkke`lbtcj`s

\oe hurre`t g`ee KTC lchtbtcj` prjhess obs severbf `j`-vbfue bllel steps, jr Kulb, b

Mbpb`ese wjrl b`l hjkkj` Xcx Xcakb terk keb`c`a wbste b`l c`eiichce`hy. Kulb c`hrebses

hjsts b`l lehrebses qubfcty b l eiichce`hy. C` jur stuly, toe Kulb steps c`hfulel kb`ubffy

settc`a up toe ckbaes prcjr tj ebho evbfubtcj` (versus b ob`ac`a prjtjhjf tobt pjpufbtel toe

hjkputer kj`ctjrs butjkbtchbffy), lchtbtc`a exbks wctojut tekpfbtes b`l usc`a lchtbtcj`

sjitwbre tobt fbhgel hjkkj`fy usel wjrls b`l kelchbf terks bppfchbdfe tj g`ee c`terpretbtcj`.

Brrb`ae ckbaes b`l fevef Qc`ljws (Ob`ac`a ^rjtjhjfs).Ci toe C\ lepbrtke`t were tj

hj`icaure persj`bfczel ckbae fbyjuts ijr ebho rblcjfjacst, toe telcjus prjhess ji

7/27/2019 Lean Management in a Radiology Department

9/23

J^CK ^E\ ^rjmeht Kby 4>28

3

kb`ubffy settc`a up toe ckbaes ijr ebho KTC g`ee exbk hjufl de efckc`btel. \ocs step

ljes `jt bll vbfue tj toe e`l resuftdut hfebrfy, ckbae hj`icaurbtcj` cs b `ehessbry step

c` toe prjhess.

Evbfubte ckbae qubfcty b`l hj`icaurc`a shjut fc`es.Ckbae qubfcty b`l shjut fc`es pfby

ckpjrtb`t rjfes c` bhhurbte KTC c`terpretbtcj`. Ojwever, ci wc`ljw fevefs b`l shjut fc`es

hjufl de set butjkbtchbffy ijr bff KTC g`ees usc`a b ob`ac`a prjtjhjf, toe` toese `j`-

vbfue bllel bhtcvctces hjufl de efckc`btel.

Tevcew b`l prjjirebl toe lchtbtel repjrt b`l hjrreht b`y errjrs.^rjjireblc`a b`l

elctc`a lj prjvcle vbfue (c.e. toey bre `jt e`tcrefy `j`-vbfue bllel). Ses, cts irustrbtc`a,

dut eve` toe dest vjche rehja`ctcj` sjitwbre kcaot kcss sjke wjrls. Bfsj, bs b kelchbf

feabf ljhuke`t, toe rblcjfjacst cs expehtel tj prjjirebl ocs/oer wjrg prcjr tj sca`c`a ct

jii. Xtcff, ckprjvel vjche rehja`ctcj` wjufl reluhe errjr rbtes b`l ckprjve lchtbtcj`

speel. Babc`, toe ajbf cs eiiehtcve eiichce`hy.

Ckprjve=B` Bfter`bte ^rjhessC` hj`suftbtcj` wcto toe rblcjfjacst, toe prckbry lrcvers ji wbste were cle`tcicel. @jw,

ckprjveke`ts hjufl de ckpfeke`tel tj kctcabte jr eve` efckc`bte toese wbste lrcvers b`l

sojrte` lchtbtcj` tcke. \oe ijffjwc`a hob`aes bre bs ijffjws= hrebtc`a b ob`ac`a prjtjhjf,

ibsocj`c`a b dbsch KTC g`ee tekpfbte b`l retrbc`c`a toe vjche rehja`ctcj` systek.

7/27/2019 Lean Management in a Radiology Department

10/23

J^CK ^E\ ^rjmeht Kby 4>28

2>

Icaure

7/27/2019 Lean Management in a Radiology Department

11/23

J^CK ^E\ ^rjmeht Kby 4>28

22

Qe bfsj rb` t-tests (see exocdct < j` pbae 25) tj hjkpbre toe lbtb sets b`l iju`l toe

lciiere`he detwee` toe keb`s tj de stbtcstchbffy sca`cichb`t ijr djtolchtbtcj` tcke b`l `ukder ji

elcts (p-vbfues 6 .>5). \ous, toe t-test vbfclbtes tobt toe pjst-prjhess lbtb obs b lciiere`t keb`

tob` toe pre-prjhess lbtb, bllc`a wecaot tj toe ckpfeke`tel prjhess ckprjveke`ts.

\oe Obwtojr`e Eiieht

Biter ckpfeke`tc`a jur prjhess ckprjveke`t, toere cs b kbrgel reluhtcj` c` tjtbf

lchtbtcj` tcke b`l `ukder ji elcts (4.2? kc`utes per KTC g`ee b`l b` bverbae reluhtcj` ji 9

errjrs). \oere bre hj`her`s tobt toe Obwtojr`e eiieht kby de pfbyc`a b rjfe dy vcrtue ji toe

rblcjfjacst g`jwc`a tobt oe wbs reblc`a b pjst-prjhess ckprjveke`t g`ee exbk.

@ext Xtep Tehjkke`lbtcj`s

\j e`sure tobt jur ckprjveke`ts obve fbstc`a vbfue, ct wjufl de wcse tj perijrk b

ijffjw-up stuly sjketcke biter jur prjhess ckprjveke`ts were ckpfeke`tel. B sehj`l t-test

hjkpbrc`a tocs `ew lbtb set tj jur pjst-prjhess ckprjveke`t lbtb wjufl sojw woetoer jur

abc`s c` tcke were lue tj us wjrgc`a j` toe prjmeht jr were b true fbstc`a tcke sbvc`a

ckprjveke`t.

B sehj`l vbfclbtcj` kcaot c`hfule rjffc`a jut toese prjhess ckprjveke`t c`ctcbtcves tj

jtoer kushufjsgefetbf rblcjfjacsts c` toe lepbrtke`t. \jtbf lchtbtcj` tcke kebsureke`ts deijre

b`l biter bppfyc`a toe `ew prjtjhjfs hjufl toe` de kebsurel b`l hjkpbrel tj e`sure tobt toe

expehtel abc`s c` KTC g`ee lchtbtcj` tcke bppfcel tj bff rblcjfjacsts. Ci toese prjhess

ckprjveke`ts sckcfbrfy ycefl pjsctcve resufts ijr b sehj`l ljhtjr, toese c`ctcbtcves hjufl toe` de

expb`lel tj jtoer kjlbfctces.

7/27/2019 Lean Management in a Radiology Department

12/23

J^CK ^E\ ^rjmeht Kby 4>28

24

De`eicts

\oe de`eicts bssjhcbtel wcto jur prjhess ckprjveke`t prjmeht=

C`hrebsel hjkpete`hces (rblcjfjacst ijhuses j` c`terpretbtcj`, `jt elctc`a b`l set-up)

Kc`ckbf tcke b`l resjurhes tj ckpfeke`t

Ebsy trb`sierbdcfcty tj jtoer lcvcscj`s wctoc` toe rblcjfjay lepbrtke`t

\cke b`l reve`ue

Teve`ue ijr b pudfch bhblekch kelchbf he`ter suho bs UHOH cs lercvel irjk toree fc`es=

resebrho, eluhbtcj`, b`l pbtce`t hbre. Bs bffulel tj ebrfcer, tcke sbvel j` KTC g`ee repjrts

hjufl keb` kjre tcke prepbrc`a ijr jtoer vbfue-bllel bhtcvctces suho bs fehtures, hj`iere`hes,

resebrho. Qocfe sjke ji toese bhtcvctces lj `jt obve b hfebr reve`ue hjkpj`e`t, toey drc`a

prestcae tj toe c`stctutcj`, c`vbfubdfe c` retbc`ke`t b`l rehructke`t ji `ew poyschcb`s, ojuse

stbii b`l kelchbf stule`ts.

\oe use ji ob`ac`a prjtjhjfs, lchtbtcj` tekpfbtes b`l vjche rehja`ctcj` retrbc`c`a

reluhel `j`-vbfue bllel tcke. ^rjluhtcvcty abc`s bre ckpfcel. \oese prjhess ckprjveke`ts

e`bdfel toe rblcjfjacst tj ijhus j` ocs hjre hjkpete`hy= c`terpretbtcj`. Ijr toe ibhcfcty, toe 2.>9,

2.53, 8.23 kc`ute tcke sbvc`as bt 2>%, 25%, 8>% ckprjveke`t, respehtcvefy, hjufl keb` b`

bllctcj`bf 22 tj 88 ojurs ji tcke sbvel woe` hjkpju`lel jver toe hjurse ji b yebr. C` jtoer

wjrls, toe rblcjfjacst hjufl de c`terpretc`a up tj 49< bllctcj`bf KTC g`ee repjrts b``ubffy bt

8>% ckprjveke`t c` lchtbtcj` tcke. C` terks ji hobraes, tobts b pjte`tcbf $

7/27/2019 Lean Management in a Radiology Department

13/23

J^CK ^E\ ^rjmeht Kby 4>28

28

\bdfe 2

Ibhcfcty Hobraes $ 2,934

^oyschcb` Hobraes $ 4?5

# G`ee KTCs (b``ubf) 925

^re-prjhess ckprjveke`t lchtbtcj` tcke (kc`utes) 2>.98

\bdfe 4= ^jst-prjhess ckprjveke`t trcbf ru` resufts

Hurre`t ^rjhess ^rjhess Ckprjveke`t

Bverbae \cke

sbvc`as

2>.98 kc`utes ?.?.39 ?9.92 44.85

\bdfe 8= Teve`ue Ijrehbst/ Xe`sctcvcty B`bfyscs

\cke

Xbvc`as/KTC

(kc`utes)

\cke Xbvc`as

B``ubf

(ojurs)

Bllctcj`bf

KTCs/Sebr

Ibhcfcty's

^jte`tcbf Fjss

Teve`ue ($)

^oyschcb

Xbvc`as/KT

B``ubffy (

2>% Ckprjveke`t 2.>9 2>.3> 9? 225,94> 23,3 2?8,984 8>,38

4>% Ckprjveke`t 4.28 42.13 25< 49>,2

7/27/2019 Lean Management in a Radiology Department

14/23

J^CK ^E\ ^rjmeht Kby 4>28

2.2>.2Bt tocs rbte, toe hobraes bre

bdjut 2>< tckes toe bhtubf hjst. Qe usel tocs rbtcj tj bpprjxckbte toe

ibhcfcty b`l poyschcb` hjsts ijr g`ee KTCs bt toe UHOH rblcjfjay lepbrtke`t, toe tbdfes defjw

sukkbrcze jur ic`lc`as=

\bdfe .28

^oyschcb` $ 28.2< $ 8.83

\bdfe 9= Sebrfy hjst sbvc`as

2ottp=//www.ht.ajv/lpo/fcd/lpo/ajver`ke`tZrefbtcj`s/4>24Zrepjrts/isrepjrtZ4>2>.pli

http://www.ct.gov/dph/lib/dph/government_relations/2012_reports/fsreport_2010.pdfhttp://www.ct.gov/dph/lib/dph/government_relations/2012_reports/fsreport_2010.pdfhttp://www.ct.gov/dph/lib/dph/government_relations/2012_reports/fsreport_2010.pdfhttp://www.ct.gov/dph/lib/dph/government_relations/2012_reports/fsreport_2010.pdf

7/27/2019 Lean Management in a Radiology Department

15/23

J^CK ^E\ ^rjmeht Kby 4>28

25

\cke sbvc`as,

b``ubf Kj`etbry sbvc`as 8-yebr jutfjjg

Ibhcfcty 44.85 ojurs $ 2>> - $2,2>> $ ?< - 3>%7 toe

rblcjfjay lepbrtke`t wrctes jii rjuaofy 25-4>% ji bff hobraes b``ubffy, tojuao tocs `ukder cs

hj`sclerbdfy fess ijr kushufjsgefetbf KTCs (bdjut 5%). Qe lcl `jt iurtoer c`vestcabte tocs cssue7

ojwever, iuture stulces kby exbkc`e hj`trjffc`a hjsts b`l ckprjvc`a hjffehtcj` rbtes.

Ckpfeke`tbtcj` Hjsts

J`e-jii, `j`-rehurrc`a hjsts c` terks ji tcke tj ckpfeke`t prjhess ckprjveke`t c`hfulel=

4> tj 8> kc`utes tj levefjp b ob`ac`a prjtjhjf

4> tj 8> kc`utes tj retrbc` vjche rehja`ctcj` j` trjudfesjke wjrls

2> kc`utes tj levefjp b tekpfbte

Ckpfeke`tbtcj` kby bfsj requcre toe oefp ji C\ persj``ef, dut jur rblcjfjacst wbs bdfe tj

ckpfeke`t toe `ew kehob`csks c`lepe`le`tfy.

7/27/2019 Lean Management in a Radiology Department

16/23

J^CK ^E\ ^rjmeht Kby 4>28

29

Hj`trjf

Hj`tc`ujus prjhess ckprjveke`t requcres hj`stb`t kj`ctjrc`a tj sustbc` toe abc`s

bhocevel. Biter c`trjluhc`a toe ckprjveke`t kehob`csks, weegfy prjhess ckprjveke`t

keetc`as b`l revcews kcaot de b hjst-eiiehtcve wby tj hj`tc`ujusfy ijster b feb` hufture bt toe

UHOH rblcjfjay lepbrtke`t.

Hj`hfuscj`

\oe uftckbte ajbf ji b`y dusc`ess jperbtcj` cs eiiehtcve eiichce`hy. B rblcjfjacsts mjd cs

`j lciiere`t. Ibhel wcto fjwer reckdurseke`ts b`l ocaoer pbtce`t vjfukes, suhhessiuf poyschcb`s

kust bfsj de feb` kb`baers, kbxckczc`a toecr tcke b`l kc`ckczc`a wbste. Qjrgifjw kust de

shrutc`czel7 reluhtcj` b`l/jr efckc`btcj` ji `j`-vbfue bllel prjhesses bre hrctchbf.

Jur pcfjt stuly sjuaot tj cle`tciy c`eiichce`hces b`l toe` ckprjve wjrgifjw usc`a b

kushufjsgefetbf rblcjfjacsts kjst ireque`t exbkc`btcj`, g`ee KTC. \oe stuly kbppel jut toe

prjhess, revebfel djttfe`ehgs b`l cle`tcicel toree prjhess ckprjveke`ts, wocho upj`

ckpfeke`tbtcj` sca`cichb`tfy reluhel tjtbf lchtbtcj` tcke b`l `ukder ji elcts. Dbsel j` jur

resufts, ob`ac`a prjtjhjfs sojufl de ckpfeke`tel woe` pjsscdfe. Ckpfeke`tbtcj` kby keet wcto

sjke rescstb`he, dut toe lbtb prjvcle b strj`a c`he`tcve ijr bljptcj`. Xckcfbrfy, dbsch tekpfbtes

sojufl de e`hjurbael. Dy utcfczc`a tekpfbtes, fess tcke cs spe`t lchtbtc`a c`tj b kchrjpoj`e,

prjvclc`a fess jppjrtu`cty ijr speeho rehja`ctcj` errjrs. Qocfe tocs kby sju`l c`tuctcve, jur lbtb

prjvcle b strj`a qub`tctbtcve mustcichbtcj`. Bs ijr vjche rehja`ctcj`, hfebrfy detter speeho

rehja`ctcj` wjufl lehrebse `ukder ji errjrs b`l elct tcke. Qocfe jur resufts lj sojw b

sca`cichb`t reluhtcj` c` errjr rbtes, jur rblcjfjacst defceves toe ckprjveke`t obs kuho tj lj wcto

toe use ji tekpfbtes wocho fckctel toe bkju`t ji lchtbtcj` tcke. C` ibht, bs per jur rblcjfjacst,

lespcte retrbc`c`a, vjche rehja`ctcj` rekbc`s sudjptckbf. Ci we were tj kebsure vjche

7/27/2019 Lean Management in a Radiology Department

17/23

J^CK ^E\ ^rjmeht Kby 4>28

21

rehja`ctcj` c` csjfbtcj`, djto deijre b`l biter retrbc`c`a toe sjitwbre, toe `ukder ji elcts wjufl

`jt obve hob`ael b arebt lebf. \ocs spebgs tj feb` kb`baeke`t, hj`tc`ubf prjhess ckprjveke`t.

B` ckprjvel vjche rehja`ctcj` sjitwbre pbhgbae, lespcte toe hjst jutfby, wjufl lehrebse toe

`ukder ji elcts b`l ckprjve tcke kb`baeke`t. Tekekder, j`e sojufl strcve ijr periehtcj`, c.e.

kbxckbf eiichce`hy b`l eiiehtcve`ess.

7/27/2019 Lean Management in a Radiology Department

18/23

J^CK ^E\ ^rjmeht Kby 4>28

2?

Bppe`lcx

Exocdct 2= Qjrg ^rjhess Kbp

7/27/2019 Lean Management in a Radiology Department

19/23

J^CK ^E\ ^rjmeht Kby 4>28

23

Exocdct 4= 1 ^rjhess Xteps ijr G`ee KTC C`terpretbtcj`

Exocdct 8= Icsodj`e lcbarbk

7/27/2019 Lean Management in a Radiology Department

20/23

J^CK ^E\ ^rjmeht Kby 4>28

4>

Exocdct 9.1? 25 2= 2=>8 =85 5

Xtlev Jfl 2=55 < 8=>? 2??.88 1 2=24 8

Xtlev Sju`a 4= < 4==>9 9

Xtlev Bd`jrkbf 4=4< < 4=54 214.8? 3 >=41 5

Xtlev @jrkbf 2=>8 4 2=>2 92..>>218.>1 82199. >

Oypjtoesczel Keb` Lciiere`he >.>>

li 19.>>

t Xtbt -8.8?81

@eels tj de

arebter jr fess

tob` 2.3321

^(\6;t) j`e-tbcf >.>>>9

@eels tj de

fess tob` .>5

t Hrctchbf j`e-tbcf 2.9954

^(\6;t) twj-tbcf >.>>22

t Hrctchbf twj-tbcf 2.3321

t-\est= \wj-Xbkpfe Bssukc`a U`equbf Ybrcb`hes

CkprjvelBd`jrkbf

C`ctcbfBd`jrkbf

Keb` 22=29 ?=54

Ybrcb`he >=42 >=25

Jdservbtcj`s 88 88

Oypjtoesczel Keb`

Lciiere`he >

li 94

t Xtbt 8.53??

^(\6;t) j`e-tbcf >.>>>8

t Hrctchbf j`e-tbcf 2.993?

^(\6;t) twj-tbcf >.>>>9

t Hrctchbf twj-tbcf 2.333>

t-\est= \wj-Xbkpfe Bssukc`a U`equbf Ybrcb`hes

C`ctcbf Elcts Ckprjvel Elcts

Keb` 25.3>44 ?.1>1821>18

Ybrcb`he 12.>45

t Hrctc hbf j`e-tbcf 2.918>88395

^(\6;t) twj-tbcf 9.9

t Hrctc hbf twj-tbcf 4.>>

7/27/2019 Lean Management in a Radiology Department

21/23

J^CK ^E\ ^rjmeht Kby 4>28

42

Exocdct 5= Xtbtcstchs sukkbryCkprjvel versus C`ctcbf Lchtbtcj` \cke

Ckprjvel

Lchtbtcj`

\cke

C`ctcbf

Lchtbtcj`

\cke

Ckprjvel

Lchtbtj` \cke

(Q/J "@jrkbf")

C`ctcbf Lchtbtcj`

\cke (w/j

"@jrkbf")

Keb` ?=41 2>=8? ?=59 22=29

Xtb`lbrl Errjr >=42 >=41 >=4< >=8>

Kelcb` ?=>5 2>=29 ?=4< 2>=

Kjle 1=>2 2>= 1=>2 2>=

Xtb`lbrl Levcbtcj` 4=48 4=5? 4=4< 4=5=2< >=44 >=2< >=42

Gurtjscs 2.>22 13 >.932 =51 29=>8 2>=43 25=24

Kc`ckuk 5=4< 9=82 25..>81??53

7/27/2019 Lean Management in a Radiology Department

22/23

J^CK ^E\ ^rjmeht Kby 4>28

44

Exocdct 1= Lchtbtcj` \cke Tu` Hobrt

Exocdct ?= Elcts Tu` Hobrt

7/27/2019 Lean Management in a Radiology Department

23/23

J^CK ^E\ ^rjmeht Kby 4>28

Exocdct 3= ^rjhess Ckprjveke`t De`eicts

^jst-prjhess ckprjveke`t trcbf ru` resufts

Hurre`t ^rjhess ^rjhess Ckprjveke`t

Bverbae \cke

sbvc`as2>.98 kc`utes ?.?.39 ?9.92 44.85

Hjst per kc`ute sbvc`as

Hjst per

kc`ute Xbvc`as

Ibhcfcty $ 1?.>8 $ 4>.28

^oyschcb` $ 28.2< $ 8.83