by following a patient from start to finish
through an appointment so that we can
improve the patient experience and achieve
an increase in throughput capacity. We will
complete this exercise by [date] and expect
to implement improved processes that
achieve a 15% throughput gain with no
increase in costs plus a 20% gain in patient
satisfaction scores by [date].”
3. What can be improved?
4. Where in the process should each step
be completed? Is there redundancy?
Where are the bottlenecks that cause
problems and introduce delays?
5. When in the process should each step
6. How can we complete the work better, easier, smarter and quicker?
This approach to changing how employees work can be used to address a single event (eg, migrating to DR from CR);
to address a single modality or room (eg, to
eliminate the fact that the MRI suite always
ends the day an hour behind schedule);
or to address department wide problems
(eg, each of the mammography rooms
has a different throughput rate). Establish
a project team for the initiative. Choose
team members for several reasons—to
ensure every step in the process is covered
include a spokesperson from each group
involved in the work. Choose people who
are knowledgeable and who are comfortable speaking out and contributing.
There are three steps involved in a process mapping project. First is to map the
way things get done today. This is the “as
is” model and is the basis for everything
to come as the project unfolds. Take a
number of flip chart sheets and stick
them on a conference room wall. Take a
variety of colored sticky notes and stick
one on the chart for each step. The more
granular, the more details emerge and
the more visibility there is to the way
things get done. Challenge and question
to make sure that every little touch point
is mapped. When it is finished, have an
all staff meeting and have the entire department critique the process map. Only
close the “as is” stage when the process
map captures everything relevant to getting the work done today.
The second step is the most fun. Ask
the same six questions that should always
be top of mind on any strategic project:
During this phase there will be some
“Just Do It” moments. The team will
look at each other and—usually—laugh
out loud at some quirk that has been dis-
covered that makes no sense whatsoever
and in just a moment it is unanimously
agreed to make an immediate change.
That is excellent because there are early
results. Just remember to document these
moments into step three of the process
During implementation, a disciplined
and strong project manager needs to be
experienced in the second tool that was
mentioned at the beginning of this article—Six Sigma. Much has been written
and many workshops have explored the
application of Six Sigma principles and
practice in healthcare and within diagnostic imaging specifically. Six Sigma is
a statistics driven approach to problem
solving and process improvement that
has its roots in high volume manufacturing. The acceptable tolerance or variance in quality when millions of units of
1. Who is doing the work each step of
2. Why is it being done that way?
Once all of the challenges, questions, and doubts are resolved
and the issues handled, the new processes are de facto accepted.
This is the point of no return for the project.