title: Improving Procedure Start Times and Decreasing Delays in Interventional Radiology: A Department's Quality Improvement Initiative.
abstract: OBJECTIVE
  To identify and reduce reasons for delays in procedure start times, particularly the first cases of the day, within the interventional radiology (IR) divisions of the Department of Radiology using principles of continuous quality improvement.
  
  
  METHODS
  An interdisciplinary team representative of the IR and preprocedure/postprocedure care area (PPCA) health care personnel, managers, and data analysts was formed. A standardized form was used to document both inpatient and outpatient progress through the PPCA and IR workflow in six rooms and to document reasons for delays. Data generated were used to identify key problems areas, implement improvement interventions, and monitor their effects. Project duration was 6 months.
  
  
  RESULTS
  The average number of on-time starts for the first case of the day increased from 23% to 56% (P value < .01). The average number of on-time, scheduled outpatients increased from 30% to 45% (P value < .01). Patient wait time to arrive at treatment room once they were ready for their procedure was reduced on average by 10 minutes (P value < .01). Patient care delay duration per 100 patients was reduced from 30.3 to 21.6 hours (29% reduction). Number of patient care delays per 100 patients was reduced from 46.6 to 40.1 (17% reduction). Top reasons for delay included waiting for consent (26% of delays duration) and laboratory tests (12%).
  
  
  CONCLUSIONS
  Many complex factors contribute to procedure start time delays within an IR practice. A data-driven and patient-centered, interdisciplinary team approach was effective in reducing delays in IR.
authors.affiliation: H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, 755 Ferst Drive NW, Atlanta, GA 30332. Electronic address: monica.v@gatech.edu.
authors.forename: Monica C
authors.initials: MC
authors.lastname: Villarreal
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Rostad
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Richard
authors.initials: R
authors.lastname: Wright
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Applegate
mesh_terms: D001071:Appointments and Schedules; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D010045:Outpatients / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000592:standards; D011300:Preoperative Care / Q000592:standards; D058996:Quality Improvement; D011872:Radiology Department, Hospital / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D015642:Radiology, Interventional / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D013997:Time Factors; D057188:Workflow
keywords: Quality improvement; interventional radiology; operating rooms/organization and administration; process improvement; systems engineering