ASU and Radiology

A Process Overview

Michael Floriani

4/26/2010

Objective

The objective of this document is to identify key stakeholders and processes associated with the “current state” handoff of patients between the Ambulatory Surgical Unit (ASU) and Radiology departments at Paoli Hospital.

The goal for this endeavor is to identify areas for potential improvement and to ensure patients are prepared and ready for Interventional Radiology procedures by a defined timeframe established by management. This timeframe, as of this document preparation, is 8:00 AM.

“Current State” Process Flow

Referring to the above flow diagram as reviewed with the Director of ASU and Director of Radiology, certain procedural changes were made during the initial plan to identify “current state” processes across identified stakeholders. These changes are reflected within the above diagram and have led to some process improvements. These are identified within the following respective areas below.

Radiology

Radiology receives requests for procedures and completes associated orders and patient information within one week of the patient’s procedure. It is uncertain if this process requires a prior patient record

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to exist in the hospital’s patient database and may be an area for further investigation. Information is transferred to registration for preregistration.

Upon completion of procedure(s), the patient is transported to ASU for post-operative recovery and then discharged when appropriate. High risk patients who may require extended hospital stays have not been documented in this process.

ASU

At the time of patient arrival, the patient is prepped and any necessary blood work is completed. Illustrated on the flow diagram, either the lab or ASU can complete this. Upon review of these results, the patient is ready for transportation to Radiology. As of this writing, there is no process other than verbal communication on the patient status unless prior understanding of having the patient to Radiology at a specified time. Furthermore, ORSOS could be utilized and management was attempting to secure system rights from the Director of Nursing to facilitate communication of patient status using this system.

CONCLUSION & RECOMMENDATIONS

Coordination of communication has occurred between ASU and Radiology since initial discussions were originally undertaken to explore areas for process improvement. This open communication and cooperation is very important in providing a more efficient and patient-centered experience and has improved patient arrival to Radiology by the goal time of 8:00. Any handoff between patients increases the chances for errors and all appropriate handoff protocols are required.

The following areas may require further investigation, depending upon current processes.

1. The coordination of patient information may require further investigation. If Radiology can enter orders without prior patient data, this would not be an issue; however, if Radiology cannot process orders without Registration first entering data, this would be function to potentially consolidate within one department.

2. Transferring medical information is another area requiring a streamlined process, especially if this requires hand-carrying information to Registration.

3. Blood work, if required, should be determined immediately upon patient arrival so that this process does not delay transporting the patient to Radiology.

4. Coordination of a bed of high risk patients may require further investigation to ensure minimal patient delay at time of post-operative recovery.

5. ORSOS should be utilized to facilitate inter-department communication of patient status.

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