title: Using Operational Analysis to Improve Access to Pulmonary Function Testing.
abstract: Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15), with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment.
authors.affiliation: W21C Research and Innovation Centre, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada T2N 4Z6.
authors.forename: Ada
authors.initials: A
authors.lastname: Ip
authors.affiliation: Operations and Supply Chain Management, Haskayne School of Business, University of Calgary, Calgary, AB, Canada T2N 1N4.
authors.forename: Raymond
authors.initials: R
authors.lastname: Asamoah-Barnieh
authors.affiliation: Operations and Supply Chain Management, Haskayne School of Business, University of Calgary, Calgary, AB, Canada T2N 1N4.
authors.forename: Diane P
authors.initials: DP
authors.lastname: Bischak
authors.affiliation: Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada T2N 4Z6; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada T2N 4Z6.
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Davidson
authors.affiliation: W21C Research and Innovation Centre, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada T2N 4Z6; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada T2N 4Z6.
authors.forename: W Ward
authors.initials: WW
authors.lastname: Flemons
authors.affiliation: W21C Research and Innovation Centre, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada T2N 4Z6; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada T2N 4Z6; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada T2N 4Z6.
authors.forename: Sachin R
authors.initials: SR
authors.lastname: Pendharkar
mesh_terms: D064790:Clinical Laboratory Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D009874:Operations Research; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires