Six Sima Case Study

Improved Essays
olutions can now begin to be generated. A problem faced daily within the HSHS-EWD prior authorization and radiology departments is orders for diagnostic testing like ultrasounds, CT scans, MRI, and PET scans being ordered incorrectly. When an order is placed it is scheduled as is, and then drops into the prior authorization work queue. An authorization is obtained prior to the scheduled appointment. The system works well, until an order is placed incorrectly and changes need to be made. This results in a delay of patient care, increased expenses due to staff time and resources, increase in appointments being cancelled and rescheduled, decreased productivity in the radiology department, and an overall decrease in patient satisfaction. Typically, the day before a procedure is scheduled the technologist review the orders with the radiologist. If a test does not meet certain imaging criteria and guidelines the doctor’s office has to be contacted to discuss protocol and have the order updated. The order then is resent to the prior authorization department who has to contact the insurance companies to reauthorize the procedure. While this is often possible, certain contrast changes are subject to review and denials. This results in having to cancel and reschedule procedures. If a technologist does not catch the incorrect order prior to the appointment, test often have to be redone on a different date of service to obtain the appropriate test for the given diagnosis and symptoms presented. It is imperative that the orders are placed properly at the beginning to avoid complications like these. In fact, the International Journal of Health Care Quality Assurance stated that when an exam is not ordered properly, it often needs to be redone with the appropriate contrast. This comes at a loss of time for the patient and the hospital, as well as, a loss of revenue. Repeat test also cause delay in the care of other patients by allocating an open spot to a patient whose exam should have already been completed. A fishbone diagram was used to assess why so many examinations are ordered incorrectly. It helped to pinpoint areas that could be worked and improved upon. Some of the key contributors toward ordering test incorrectly are: orders are difficult to read, doctor’s offices place unspecific orders, radiology protocol is unknown, and communication between radiology technicians and doctor’s offices are lacking. One of the first key contributors is that orders are difficult to …show more content…
It was determined that several doctors are still ordering test on paper and not using the electronic resources allotted to them. As a result, nurses are guessing at the appropriate contrast required for the examination. In an article published in the International Journal of Health Care Quality Assurance they looked at decreasing medical diagnostic imagine errors using the Six Sima methodology. One of the focuses was the lack of physician knowledge and competency. The study discovered that orders written on paper caused an increase in wait times and delays in diagnosis due to not being able to properly read the order. (Taner, Sezen, Atwat 274-290). The next contributor is that doctors are placing unspecific orders. For example, they are ordering a CT scan of the chest but not specifying if it is to be with or without contrast. When the nurses contact the scheduling department, they are often guessing at the contrast requirements. This leads to an increase of incorrect

Related Documents

  • Great Essays

    Case Study Of Quinte MRI

    • 2569 Words
    • 11 Pages

    Patients must first receive a referral from their doctor 2. Patients or doctor’s assistant contact the MRI scheduling department to get appointment 3. Receptionist at scheduling department writes the patient’s name and type of procedure on the daily schedule form (8 time slots, each for a one-hour increment) 4. Patients check in with the receptionist upon arrival and wait for the MR technologist to escort them to the MR machine in the magnet room 5. Patients are questioned about possible health risks and if detected, they get sent home 6.…

    • 2569 Words
    • 11 Pages
    Great Essays
  • Decent Essays

    Over the last 20 years an increasing development of the understanding of how physicians combine medical knowledge and clinical skills in the clinical judgement process. This process, the creation of a problem representation referring to what the physician thinks occurring with the patient based on the synthesis and integration of two key elements. The first element includes the information collected from the patient through an accurate and the complete medical history. The second element includes a focused physical examination, and the physician’s working medical knowledge.…

    • 159 Words
    • 1 Pages
    Decent Essays
  • Decent Essays

    It is very important that a patient receives testing and efficient care in a timely manner to prevent long-term health issues.…

    • 114 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    SPA 6 Case Study

    • 453 Words
    • 2 Pages

    The current population of SPA 6 / South Los Angeles is 1,307,402 including homeless residents (Los Angeles County. Office of Health Assessment and Epidemiology, 2017), and although small, measuring 71.3 square miles, SPA 6 is the most densely populated area in LA County (TCCSC, 2017). In terms of gender, it is about equally divided, with 51% females and 49% males. The ethnicity breakdown is, 68.2% Latino, 27.4% African American, 2.4% Caucasian, 1.7% Asian, 0.2% Asian Pacific Islander (API) Indian, and 0.1% American Indian. A good portion of the population (35.3%) falls in the age range of 18 – 39 years old.…

    • 453 Words
    • 2 Pages
    Improved Essays
  • Decent Essays

    There’s discrepancies between the optimal patient care and current care is provided. That issue was addressed by the Canadian Patient Safety Institute (CPSI) Which establish measures to encourage improvement of patient safety and quality of care. Ultimately, the government of Ontario issued a bill and some specific acts to overcome this issue. Grand River Hospital (GRH) includes over 3,500 staff who serve over 23,391 newly admitted patients and almost 281,824 patients through outpatient clinics, emergency departments and one-day surgery visits. GRH establish a quality framework by strategic planning and developed specific goals regarding accessibility, appropriateness, safety and patient experience of care.…

    • 345 Words
    • 2 Pages
    Decent Essays
  • Improved Essays

    SBAR COMMUNICATION TOOL The Situation, Background, Assessment, and Recommendation (SBAR) is a communication tool that provides a structure for critical conversation requiring healthcare providers immediate attention and action (Mason, Leavitt & Chaffee, 2014, p. 433). The purpose of the SBAR is to improve communication between nurses and physicians in an emergent situation; it can make communication more consistent and predictable (Cornell, Townsend, Yates & Vardaman, 2014). The joint commission recommends the use of the SBAR tool to improve communication (Joint Commission on Accreditation of HealthCare Organizations, 2012). It provides a consistent method of hands-off communication that is clear, structured, and easy to use.…

    • 554 Words
    • 3 Pages
    Improved Essays
  • Superior Essays

    Nurse to Nurse Incivility and How it Affects Performance Clinical Question Problem description The nursing profession has high rates of cases of incivility among the profession. Uncivil behavior at the workplace entails violence at the workplace, intimidation, withholding of critical information, public humiliation and intimidation and stealing credit for work not done (Casale, 2017). Despite the nursing profession being based on ethics and values of respect and integrity, it has been reported that more than eighty-five percent of registered nurses were victims of nursing workplace incivility (Casale, 2017).…

    • 1205 Words
    • 5 Pages
    Superior Essays
  • Superior Essays

    This may include, but not limited to procedures, medication tests, and…

    • 945 Words
    • 4 Pages
    Superior Essays
  • Improved Essays

    Nurse Staffing Ratios

    • 1176 Words
    • 5 Pages

    Mandatory Nurse Staffing Ratios Policy Problem Nurse staffing ratios have been the center of countless studies and debates. Research has shown that better nurse staffing ratios decrease patient and nurse injuries, poor patient outcomes, and sentinel events. Multiple factors must be taken into account when forming appropriate patient assignments. The largest of those factors being the increase in patient acuity and decrease in nursing staff. “When health care employers fail to recognize the association between RN staffing and patient outcomes, laws and regulations become necessary” (American Nurses Association, n.d.).…

    • 1176 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    Patient Care Technology Paper Technology plays a huge role in the nursing world today. Technology contributes to safe patient care, nursing education and communication between an interdisciplinary team. This paper will discuss three of the many important aspects of technology within patient care. Within this paper electronic documentation, cardiac telemetry and electronic medication cabinets will be acknowledged.…

    • 854 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    In the U.S., the third leading cause of death is not a topic the general public knows and talks about: medical mistakes. According to the Journal of Patient Safety, between 210,000 and 440,000 patients suffer some type of harm. The medical system should change so there are more people double-checking every detail, the hours of doctors shifts are reduced and the topic of medical malpractice is openly discussed. In life or death situations, every small detail needs to be checked and double checked to reduce the likelihood of error. There are far too many examples where negligence by any of the medical staff has led to a patient suffering the consequences.…

    • 593 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    A current major healthcare problem in the United States is the lethal combination of medical error and patient neglect. Medical mistakes are the third leading cause of death nationwide and are responsible for over 400,000 deaths annually. A major contributor to these errors is understaffing. A shortage of hospital workers, nurses in particular, can be detrimental to patient care. Patients are dependent upon being treated in a timely fashion, along with the absolute best care possible.…

    • 359 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    When this is done incorrectly, it results in it being the most common reason for a competence notification to the Nursing Council (Cook, 2014). Some factors that can lead to administering of medication errors are loss of concentration, interruptions, not following the proper procedure, stress in the workplace, being understaffed and the nurses health status (Cook, 2014). It is why critical thinking is needed to avoid these errors in medication, but also in patient care. Her understanding of nursing practices allowed her to question the soundness of the care plan change, and realize that it made no sense in the circumstances. Having observant nurses, that take care to understand their patients care plans and treatments, protects the patients from mistakes that can occur in such a large organization.…

    • 764 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Additionally, a lack of adequate support systems, skills and personal accountability results in communication gaps that can cause harm to patients. “(U.S.Newswire,2006.) As with any situation; with the good comes the bad and poor communication in outcomes. Among these flawed actions often reported on are; when staff take shortcuts that could be dangerous or fatal to their patients care or show poor clinical judgment. Staff that directly confronts their colleagues about their concerns could cause harm to come a patient as a result, due to unprofessional behavior or attitude.…

    • 805 Words
    • 4 Pages
    Improved Essays
  • Superior Essays

    During a patient visit, both the patient and provider must decide on which health issues to discuss. The provider must also decide on what care to provide the patient within the limited time frame of the appointment. By introducing a new guideline, another may be dropped, resulting in the rationing of care. The discontinued care is the opportunity cost of implementing the new guideline. Even when a provider is able to follow all guidelines on a given patient and spends the extra time required to do so, opportunity cost still occurs.…

    • 1081 Words
    • 5 Pages
    Superior Essays

Related Topics