Using mixed model research to evaluate the outcomes of a lean approach to the transformation of an orthopaedic radiology service

The purpose of the study was to explore the proposition that lean is aneffective methodology for service improvement within a healthcare setting byevaluating the changes brought about by the application of lean tools to anorthopaedic radiology pathway in a large DGH. Delivery of this service waspoor with long waiting times and poor levels of satisfaction amongst patientsand staff. This service was evaluated using lean tools in order to identify areasfor improvement, and changes were made in the form of a self containedRadiology suite within the Orthopaedic Out Patient department. Changeswere also made to the booking templates and the pathway through thedepartment. Staffing levels remained the same, with rosters being changed toinclude cover for the new department.A mixed model approach was used, with qualitative and quantitative databeing collected from staff and patients both before and after the changes tookplace. The qualitative data consisted of questionnaires completed by staff andpatients. The quantitative data was predominantly related to waiting times andwas gathered from the Radiology Information System, with some quantitativedata being taken from the questionnaires. A comparative analysis of the twoservices was conducted in order to determine if the changes were consistentwith the lean philosophies of 'elimination of waste' and 'respect for people'.The results revealed that the time spent by the patient in clinic and radiologyhad reduced by up to 69.59% and 66.27% respectively, with a reduction in patients having to wait longer than 30 minutes for their x-ray of 94.93%. Thelocation of the department influenced this reduction as the distance travelledby the patient reduced by up to 60.53%. A further factor was the separation ofOrthopaedic patients from Emergency Department patients, leaving theradiographers with only one patient pathway to focus on and a reduction of60% of radiographers feeling that they had conflicting demands on their time.This increased the levels of patient and staff satisfaction. Furthermore, therewas a reduction of 54% in the median waiting time for Emergency Departmentpatients attending radiology.The author proposes that these findings support the proposition that lean isan effective methodology for service improvement within a healthcare setting.

Level dc:type.qualificationlevel

Doctoral (Level 8)

Year dc:date.issued

2011

Author dc:creator

• Martin, AJ

Language dc:language

en

Identifier

oai:salford-repository.worktribe.com:1337040

OAI identifier oai:identifier

oai:salford-repository.worktribe.com:1337040