Simplifying hospital processes can produce improvements in care Scrapping radiology appointments in favour of a walk-in system increases patient and staff satisfaction

The use of business administration models can improve radiology processes in hospitals. This is the finding of a study carried out by Jasper van Sambeek, who will be defending his PhD thesis at the University of Twente on 4 May. Van Sambeek showed, for example, that scrapping appointments in favour of walk-in systems enabled departments to deal with patients requiring CT scans more quickly. At the same time, capacity utilization rates remained the same or even increased. 

According to Van Sambeek, there is no organization more complex than a hospital. In many ways, they are completely unlike ‘normal companies’. Nevertheless, business administration models – if used properly – have great potential in terms of improving patient logistics. His PhD research focused on methods for optimizing the processes involved while, at the same time, improving the service to patients. He focused on radiology departments because increasing numbers of patients are now using these facilities, and because the waiting times involved are often less than ideal. Also, the equipment is very expensive, so it is important for it to be used as efficiently as possible. Van Sambeek carried out a literature survey as well as various case studies, in addition to using computer simulations. His research focused on the situation from the viewpoint of each of those involved – the hospital managers, the healthcare professionals and the patients. 

Reducing variation

The general conclusion to be drawn from Van Sambeek's research is that many healthcare processes can be improved by reducing variation. One example of this is a case that Van Sambeek worked on at the Academic Medical Center (AMC) in Amsterdam. He simulated a new planning strategy to reduce access times (the time patients have to wait before being seen) for the MRI facilities. Those departments have defined a large number of different patient groups (in the belief that this approach is more efficient), each of which is dealt with differently in the scheduling. The simulation showed that if this number was substantially cut, access times could be reduced by up to 93%. Following the implementation of this strategy at the AMC, access times were indeed reduced – from several weeks to a few days. 

No appointments

Another way of shortening access times is to enable patients to visit the radiology department without first having to make an appointment. In practice, hospitals usually opt for an appointment system, on the assumption that this is a better way of spreading out the influx of patients. The disadvantage, however, is that it involves more trips to hospital for patients, and it takes longer to reach a diagnosis. In practice, patients usually have to wait one or more weeks before they can be scanned. Van Sambeek points out that “This period can often be reduced to zero.”

One of the findings of a case study at Rijnstate Hospital was that if patients can have CT scans without first making an appointment, they might have to wait a few minutes longer in the waiting room, but tend to be more satisfied. The reason is that they do not have to make so many trips to hospital and the scan is carried out much earlier. As a result, the patients get their results much sooner. The study has shown that the system does not involve any compromises in terms of efficiency. Indeed, the facilities’ capacity utilization rates appear to be even higher than before. The staff, too, are more satisfied with this system. While things might be very hectic at peak times, they nevertheless feel that it enables them to provide patients with a better service. 

PhD defence

Jasper van Sambeek conducted his PhD research at the Department of Technology Management and Supply. He was supervised by Prof. Koos Krabbendam and Prof. Erwin Hans. The public defence of the PhD thesis will take place at 16:30 on 4 May, in the Prof. G. Berkhoff Hall in the Waaier building on the University of Twente campus. Van Sambeek is currently working as a director at Sleutelnet (a joint venture by various healthcare sector parties in the Zuid-Holland North region) in the area of healthcare communication.