Learning from a Process Improvement Project

By Bradford Harrold, BS, RT(MR), ARMRIT

The Partners in Learning program was a great opportunity for me to broaden my vision and be exposed to new practices. My host, Lisa Fletcher, the Radiology Director at Robert Wood Johnson (RWJ) University Hospital, scheduled a great variety of meet and greets for me throughout the department and hospital. RWJ has two campuses, is magnet certified, and performs close to 400k exams yearly. My time there was well spent as I was able to fully take off the firefighter hat we all so frequently wear. Being able to observe and analyze without interruption was worth volumes.

RWJ has a unique approach when it comes to patient care improvement. They have a dedicated team of Lean black belts. Once someone has completed the Lean training program, they are then assigned a project to complete. The projects range from turn around time and dashboard initiatives, to performance improvement using their QA program. One example of an improved process from their Lean team is the utilization of iPads to check for additional orders when an X-ray technologist is in the ED or otherwise away from their home department. Historically, when an order came for a portable exam, the technologist would leave the department, shoot that one portable, and then go back to their department to update the exam and check for the next portable order. This resulted in a lot of wasted time because the technologist was only able to shoot one exam at a time. Currently, that same technologist can use the iPad, which has all orders listed in real time. There is no more wasted time going back and forth between departments, resulting in a much more efficient process and improved work flow.

Lisa and I also discussed MRI safety and how to increase awareness around it. RWJ uses ferromagnetic detectors in the door frame when going from zone 3 to zone 4, which seems to result in alarm fatigue for the RWJ MRI techs. This is also the case for the MRI techs at my facility. Passive systems are not as robust a tool compared to other available options, such as using wands to screen for and catch unsafe devices. Wanding is a conscious effort that is underutilized, yet very valuable and cost effective, as opposed to hearing an alarm that you can subconsciously ignore.

We also discussed the need for and value of creating an MRI safety committee that would be integrated with all relevant departments. Ideally it would include representatives from quality, safety, anesthesia, compliance, and senior leadership. They would review all near misses and sentinel events. The committee would be responsible for annual training for both level 1 and level 2 MRI personnel. This committee would fulfill the recommendation of the ACR, ensuring that MRI safe practice guidelines are established and maintained as current and appropriate for the site.

The Partners in Learning program helps bridge the gap between current practice and the implementation of emerging technologies. Brainstorming with others who are struggling with the same challenges and getting new perspectives was very helpful. I emphatically encourage all to consider the Partners in Learning experience, as it has much to offer.

Note: Applications to become a Partners in Learning host site are open now through April 21! If you’d like to host another AHRA member at your facility, click here to apply.

Bradford Harrold, BS, RT(MR),ARMRIT is the imaging services assistant director at Kaiser Permanente-Oakland Medical Center in Oakland, CA. He can be reached at Bradford.j.Harrold@kp.org.