kj case studies to rk wo popups ending point

Ron,

Attached are the descriptions of three case studies. Would you like to review the outcomes?

#1. To improve upon the design of a CT suite recommended by a vendor.

#2. To expedite the installation of a radiographic room for use by the Emergency Department.

#3. To refine the design of filmless reading rooms for the transition from film-based reading rooms to digital reading stations.

Ken

Example #1. Vendor’s recommended CT Design

Questions, concerns, suggestions for improvement?

4’ 11”

Questions, concerns, suggestions for improvement?

4’ 11”

Questions, concerns, suggestions for improvement?

Key TakeawayBe extremely cautious of installation advice provided by vendors.

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Example #2. Actual Case Study Expedite installation of an emergency radiographic room

Starting Point:• Current room to be taken out of service within 30 days

• Am not to look at anything else whatsoever for following reasons:

1. Any other changes would jeopardize getting this room installed quickly.

2. There are – and will NOT be - any funds approved for doing anything else for at least one year if not more.

Room dimensions:20’ x 24’

Typical radiographic equipment• Chest board for chest x-rays on back wall• Radiographic table on which some patients lay• X-ray tube hangs from ceiling mounting so it can move

about the room to aim in any direction• Casework for supplies

Source: Google: Radiographic room design. Then select: “Images for radiographic room design”,

Typical radiographic equipment• Chest board for chest x-rays on back wall• Radiographic table on which some patients lay• X-ray tube hangs from ceiling mounting so it can move

about the room to aim in any direction• Casework for supplies

Source: Google: Radiographic room design. Then select: “Images for radiographic room design”,

Key TakeawayAlways identify an existing site to use as a benchmark for your design early in your planning process.

*To see this drawing as well as many photographs of radiographic rooms, Google: Radiographic room design. Then select: “Images for radiographic room design”, “Images for . . .”

AssignmentSeen below is a layout for a radiographic room that pops up if you go to the Google site listed below*. Using this layout or other information from this web site, create a layout on the attached slide which is to be turned in at the start of class on Tuesday.

*To see this drawing as well as many photographs of radiographic rooms, Google: Radiographic room design. Then select: “Images for radiographic room design”, “Images for . . .”

AssignmentSeen below is a layout for a radiographic room that pops up if you go to the Google site listed below*. Using this layout or other information from this web site, create a layout on the attached slide which is to be turned in at the start of class on Tuesday.

Key TakeawayBe extremely cautious of advice from Internet. Watch for red flags.

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Print Name (legibly) _________________

Classroom exercise #1 for ISE 541Recommended design for a radiographic roomTurn in at start of class on Tuesday

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Actual Case Study Expedite installation of an emergency radiographic room

Starting Point:• Current room to be taken out of service within 30 days

• Am not to look at anything else whatsoever for following reasons:

1. Any other changes would jeopardize getting this room installed quickly.

2. There are – and will NOT be - any funds approved for doing anything else for at least one year if not more.

Room dimensions:20’ x 24’

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ED

Supplies

1

4

3

2

EmergencyDepartment

Existing Conditions1. Current ED Radiographic Room to be taken out of service within 30 days to create new Corridor

2. CT for Emergency use is in NE corner of Radiology Department

3. Single slice CT is obsolete, not used for Emergency work. CT to be replaced in future.

4. Second MRI needed. Plans being developed to install in vacant interventional room.

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ED

Supplies

1

4

3

2

EmergencyDepartment

Key TakeawayCreate a “Functional Drawing” for conducting an initial current state assessment to understand the big picture.

Existing Conditions1. Current ED Radiographic Room to be taken out of service within 30 days to create new Corridor

2. CT for Emergency use is in NE corner of Radiology Department

3. Single slice CT is obsolete, not used for Emergency work. CT to be replaced in future.

4. Second MRI needed. Plans being developed to install in vacant interventional room.

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New corridor

Outcomes:1.Expanded space allocated from renovation from Angio Supply Room only to that seen above2.Gained approval to install new CT within this space..

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New corridor

Outcomes:1.Created an MRI suite which also freed up space for future interventional work..

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New corridor

Outcomes:1.Created an MRI suite which also freed up space for future interventional work..

Key TakeawayUse “Functional Drawing Tools and Techniques to improve upon drawngs done by architects..

• Radiographic room was enlarged and redesigned.

• An Emergency Room suite was created with CT and Radiographic Rooms along with ancillary support spaces..

• A second MRI was justified and installed within space previously occupied by a CT

Net Result of Intervention and Use of Tools

Example #3: Dartmouth-Hitchcock Medical Center

“Minimizing the spaghetti.”

KJA

1. “To look only at design of new filmless radiology reading rooms (PACS) and nothing else.”

2. “Do not expect to make any changes as project is over budget and behind schedule.”

3. “CT suite is absolutely off limits. It is done.”

Conditions of Engagement:

KJ/MCExample

Example of one of the proposed designs for filmless reading room. What, if any, changes would you propose for this reading room?

Optimizing Radiology Workflow and Productivity

Monte G. Clinton, FAHRAAdministrative Director

Dartmouth-Hitchcock Medical Centermonte.g.clinton@hitchcock.org

Kenneth C. JohnsonPresident

Kenneth Johnson and Associates, Inc.kjandassoc@aol.com

AHRA 2003 Annual Meeting

Dartmouth-Hitchcock Medical Center

Dartmouth-Hitchcock Medical Center Hospital Corridor

Workflow Analysis Techniques

Create drawing to illustrate workflow at 15,000’Case Study: Dartmouth-Hitchcock Medical Center

“No changes to be made to basic design, but was givenapproval to suggest refinements.”

IP

OP, ED

Workflow Analysis Techniques

Continue to zoom in and analyze workflow from everyone’s perspective.

Color Code

Red = Patient

Blue = Technologist

Green = Radiologist

Workflow Analysis Techniques Analyze workflow by tracing everyone’s footsteps

Key TakeawayUse “Spaghetti Drawings” to first understand workflow, then improve upon it.

Color Code

Red = Patient

Blue = Technologist

Green = Radiologist

Workflow Analysis Techniques Analyze workflow by tracing everyone’s footsteps

Yellow shaded area represents operator’s line of vision when looking at console. To see patient, operator looks to left.

Note challenge in getting patient into room, particularly if IV pole, etc.

Workflow Analysis Techniques

Zoom in until at “ground level.”

Workflow Analysis Techniques

Simulate the design using scale models putting yourself in the driver’s seat.

Proposed design before simulation

Workflow Analysis Techniques

Involve radiologists and all staff in simulating various designs.

Design resulting from simulation.

Workflow Analysis Techniques

Involve radiologists and all staff in simulating various designs.

Design resulting from simulation.

Key TakeawayConduct full-scale mock-ups or use scale models to develop designs and illustrate the final outcome you desire..

Workflow Analysis Techniques

Strive to minimize the travel for all parties

(Minimize the spaghetti)

Design resulting from simulation.

4th CT moved to Emergency Department.

• One CT was moved to ED.

• CT Suite was redesigned to improve workflow.

• Designs of PACS reading rooms were significantly improved upon.

Net Result of Intervention and Use of Tools

KJ/MC

Comments?

Questions?

Feedback?

Monte G. Clinton, CRA, FAHRAmonte.g.clinton@hitchcock.org

Kenneth C. Johnson, Presidentkjandassoc@aol.com