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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.

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radiation oncology report turn around time

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
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
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
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 pick-ups @ 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
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 room @ 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

slide6

Results and Analysis

Report Availability and Distribution (following ROIS implementation)

35

30

25

20

15

10

5

0

Before

After

Before and After Intervention

Delivery

Transcription

Approval

conclusions
Conclusions
  • Change to date of service workflow reduced overall TAT.
    • 24-32 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
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.