An optimization based on simulation approach to the patient admission scheduling problem: Diagnostic imaging department case study

The growing influx of patients in healthcare providers is the result of an aging population and emerging self-consciousness about health. In order to guarantee the welfare of all the healthcare stakeholders, it is mandatory to implement methodologies that optimize the healthcare providers' efficiency while increasing patient throughput and reducing patient's total waiting time. This paper presents a case study of a conventional radiology workflow analysis in a Portuguese healthcare provider. Modeling tools were applied to define the existing workflow. Re-engineered workflows were analyzed using the developed simulation tool. The integration of modeling and simulation tools allowed the identification of system bottlenecks. The new workflow of an imaging department entails a reduction of 41 % of the total completion time. © 2013 Society for Imaging Informatics in Medicine

Evaluating the impact of service delivery initiatives on patients’ waiting times in diagnostic radiology: a mixed methods study

This thesis describes the impact of service delivery initiatives (SDIs) on patients’ waiting times within radiology departments. A systematic review of the literature (71 studies included) found the following broad type of SIDs: extended scope practice, quality management, productivity-enhancing technologies, outsourcing, pay-for-performance and multiple interventions. Ninety-six percent of the studies used either the pre- and post-intervention without control or the post-intervention only designs; but these designs are fundamentally weak and prone to bias. Furthermore, this thesis also described a case-study for the evaluation of the impact on patients’ waiting times of a 320-slice computed tomography (CT) scanner, speech recognition reporting and extended-working-hours within the Birmingham Heartlands Hospital (Heart of England NHS Foundation Trust), Birmingham. The evaluation combined the interrupted time series (ITS) design and qualitative interviews with healthcare professionals in a mixed methods approach. The mixed methods approach leverages the strengths of the quantitative and qualitative methods, so that the triangulation of the findings of one research method might be strengthened when supported by the findings of the other research method. The thesis used a distinctive implementation of ITS segmented regression which accounts for the changing trends of patients waiting times – an approach referred to as ITS ‘segmented spline’ regression

Redefining the sonography workflow through the application of a departmental computerized workflow management system

Purpose: The purpose of this study is to demonstrate and evaluate the effective application of a computerized workflow management system (WMS) into sonography workflow in order to reduce patient exam waiting time, number of waiting patients, sonographer stress level, and to improve patient satisfaction. Methods: A computerized WMS was built with seamless integration of an automated patient sorting algorithm, a real-time monitoring system, exam schedules fine-tuning, a tele-imaging support system, and a digital signage broadcasting system of patient education programs. The computerized WMS was designed to facilitate problem-solving through continuous customization and flexible adjustment capability. Its effects on operations, staff stress, and patient satisfaction were studied. Results: After implementation of the computerized WMS, there is a significant decrease in patient exam waiting time and sonographer stress level, significant increase in patient satisfaction regarding exam waiting time and the number of examined patients, and marked decrease in the number of waiting patients at different time points in a day. Conclusion: Through multidisciplinary teamwork, the computerized WMS provides a simple and effective approach that can overcome jammed exams associated problems, increase patient satisfaction level, and decrease staff workload stress under limited resources, eventually creating a win–win situation for both the patients and radiology personnel