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Meeting the Targets!

Meeting the Targets!. The Crosshouse Journey. Outline. Who are we? Brief History Interim Measures Changes in work practice! How are we doing? The Future – is it bright?. Who are we?. Larger of 2 DGHs 527 beds (570) Area Beds: Paeds Gyn Nephrology Dermatology ENT Maxfac

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Meeting the Targets!

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  1. Meeting the Targets! The Crosshouse Journey

  2. Outline • Who are we? • Brief History • Interim Measures • Changes in work practice! • How are we doing? • The Future – is it bright?

  3. Who are we? • Larger of 2 DGHs • 527 beds (570) • Area Beds: • Paeds • Gyn • Nephrology • Dermatology • ENT • Maxfac • 1 MRI scanner – age 7 • 1 CT scanner – age 3 • MRI GA service

  4. Introducing the Targets: • August 2007 ‘Diagnostic 4 week target will take effect from December 2010 – there should be additional resources’ (GR) • In preparation AAHB Radiology - 6 weeks from now!

  5. Brief History • August 2007: • CT: 5wks; MRI: 9wks • ~7,000CT; 3,700MRI • 9am – 5pm, Monday – Friday, 9am – 12pm Saturday (Stroke Service) • (39 hour CT week; 36 hour MRI week) • 4.75 WTE radiographers(6 staff); 2 WTE helpers • 5 departmental porters

  6. Interim Measures • Capacity and Demand Audit • 111% MRI; 110% CT • Process Mapping • Forget lunch! • Canvas staff • Voluntary overtime – loyal! • Clear the backload! • Outsource reporting for MRI • Extra session reporting • (2 qualified Cranial CT Reporting Radiographers still not supported to practice) • Patients scanned and reported at GJH and CG

  7. The More You do………………. • January 2009 (16 months down the line) • CT: 8wks; MRI: 9wks • ~9,600CT (37% ); 4,600MRI (24% ); • 9am – 5pm, Monday – Friday, 9am – 12pm Saturday (Stroke Service) • Minimum of 5 OT sessions per week • (47 - 51 hour CT week; 42 - 48 hour MRI week)

  8. It’s not ALL about targets! • After a year of OT • De-motivated – lack of solutions • Tired • Crabbit • Stress • Clinical risk • Recalls THEN - “4 weeks by March” NO APPARENT END

  9. SO……. • Overtime ended till there was a ‘PLAN’ • Waiting lists not maintained

  10. Sustainable solutions - • Ideal Service? • Formalise the 12 hour days • Rota(s) proposed • Staff involved • Requirements: • 4 additional WTE staff • 1 additional WTE assistant • Funding was put in place for the Radiographer posts!

  11. Balance restored! • 4 posts to advert closing date May • OT supported again • 12 hour days commenced October 2009

  12. 12 hour shifts!

  13. 12 hour shifts!

  14. One year down the line: • 8.8 WTE Radiographers (11 staff) • 3 WTE Assistants (1 still not fully funded) • 4 Departmental Porters • CT: • 8am - 8pm Monday – Thursday • 9am – 5pm Friday and Saturday • MRI: • 8am – 8pm Monday – Friday (64 hour CT week; 60 hour MRI week)

  15. Benefits of 12 hour days:

  16. Benefits of 12 hour days:

  17. Patient Benefits of 12 hour days: • Reduced waiting times - • Reduced anxiety • Increased flexibility • Increased access • Faster turnaround in Department with still more time to talk! • Increased in-patient capacity – no more ‘bed-blocking’! • Happy patients – even on a Saturday!!

  18. Staff Benefits of 12 hour days • Improved Radiographer involvement • Improved morale/job satisfaction • Decreased external pressure • Improved development/training opportunities • Great flexibility • Less pressure on the sessions • Decreased recall rate – no more ! • Happy Radiologists? • No need to be on site!

  19. Service Benefits • Better utilisation of the equipment • Reliable Service • Improved quality of Service • Improved relations with referrers “Great service” Itamar Felsenstein

  20. Where we stand now - 6months later (Figures as of 5th March) • CT: • 10,500 CT (9%); • 9 day wait to appointment • 99.2% completed in target • MRI: • 5,100 MRI (11%); • 22 day wait to appointment (patient type) • 93% completed in target 5 Departmental Porters • Jan 2008 42% CT exams IP, 13% MRI exams • Jan 2010 47% CT exams IP, 15% MRI exams

  21. However: • Frustrated Service Development • CT Colonography • GI MRI • Stroke MRI • Cardiac CT/MRI “CT Coronary Angiography should be developed as a decentralised service” WoS RPG • Shortage of Permanent Radiologists • 5 WTE Consultants • Total annual throughput 105,500 exams per annum • 2 ‘permanent’ Locum Consultants (2 qualified Cranial CT Reporting Radiographers still not supported to practice)

  22. Are we there yet? • NO! • MRI • Limited reporting time • Still ‘breachers’ • Protocol • Inject/Vet

  23. Acknowledgements: • Clinicians • Radiologists • Theresa Holliman WLC But most of all: • My Team Fiona, Jacqui, Penny, Sandra, Leigh, Mhari-Clare, Angela, Marion, John, Kim and Jillian, Joan, Linda and Anna Craig and Eleanor

  24. Any: Comments? Questions? Concerns? Solutions??

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