Small Schedule Changes Improve MRI Access, Lower Costs
The MRI unit at Kaiser Sunnyside Medical Center had a challenge.
The department was receiving an average of 120 cases each day, but they were able to see only 71. As a result, patients were being referred outside of the Kaiser Permanente system. This drove up referral costs, inconvenienced KP members, and increased dissatisfaction.
In addition, referring patients to outside services posed a delay in getting results back to the ordering doctors. Schedulers who received the request for appointments also had a tough job—when they were not able to accommodate patients within the KP system, they had to make arrangements with outside services, which took additional time.
And finally, the patients didn’t like it.
The feedback from patients to department manager David Barry, was that they didn’t want to have to go elsewhere for services. Patients preferred to have their MRIs performed at the Sunnyside Medical Center.
The team's first step was to increase capacity to see more patients and reduce outside referrals by at least 10 per week within two weeks. To acccomplish this, they reduced the overlap in staffing and changed the schedules of two technologists, increasing their ability to see more patients.
The new staffing schedule, which didn’t infringe on union contracts, came out of a brainstorming session and was supported by staff and physicians.
After the first two technologists adjusted their schedules, a third technologist, seeing the difference it made, offered to adjust his schedule. By the end of one week, about 15 more patients were added to KP’s schedule and not referred to outside services. This resulted in a cost savings of about $7,500 per week, or about $30,000 per month.
"One of the big advantages that we have found is that we have openings for certain appointment types within a day or two, not a week or two," says labor co-lead Heather Thompson.
In addition to the work done in the UBT, a mobile scanner was added to the department. This enabled an additional 11 patients per day to be seen—or about 55 patients per week—for an additional per week savings of $30,000 in outside referral costs.
"There is a downside to that, though,” Thompson says. “Since patients are able to get the appointment so quickly, it seems as though we have a lot more short-notice cancellations and we do not have a wait list to fill them with. That is something that we will need to monitor and try to come up with a solution to."
Sunnyside Medical Center's MRI department was receiving more cases each day than it could handle.