Using mixed model research to evaluate the outcomes of a lean approach to the transformation of an orthopaedic radiology service

Martin, AJ

Abstract

The purpose of the study was to explore the proposition that lean is an
effective methodology for service improvement within a healthcare setting by
evaluating the changes brought about by the application of lean tools to an
orthopaedic radiology pathway in a large DGH. Delivery of this service was
poor with long waiting times and poor levels of satisfaction amongst patients
and staff. This service was evaluated using lean tools in order to identify areas
for improvement, and changes were made in the form of a self contained
Radiology suite within the Orthopaedic Out Patient department. Changes
were also made to the booking templates and the pathway through the
department. Staffing levels remained the same, with rosters being changed to
include cover for the new department.
A mixed model approach was used, with qualitative and quantitative data
being collected from staff and patients both before and after the changes took
place. The qualitative data consisted of questionnaires completed by staff and
patients. The quantitative data was predominantly related to waiting times and
was gathered from the Radiology Information System, with some quantitative
data being taken from the questionnaires. A comparative analysis of the two
services was conducted in order to determine if the changes were consistent
with the lean philosophies of 'elimination of waste' and 'respect for people'.
The results revealed that the time spent by the patient in clinic and radiology
had reduced by up to 69.59% and 66.27% respectively, with a reduction in patients having to wait longer than 30 minutes for their x-ray of 94.93%. The
location of the department influenced this reduction as the distance travelled
by the patient reduced by up to 60.53%. A further factor was the separation of
Orthopaedic patients from Emergency Department patients, leaving the
radiographers with only one patient pathway to focus on and a reduction of
60% of radiographers feeling that they had conflicting demands on their time.
This increased the levels of patient and staff satisfaction. Furthermore, there
was a reduction of 54% in the median waiting time for Emergency Department
patients attending radiology.
The author proposes that these findings support the proposition that lean is
an effective methodology for service improvement within a healthcare setting.

Citation

Martin, A. Using mixed model research to evaluate the outcomes of a lean approach to the transformation of an orthopaedic radiology service. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Aug 18, 2021
• Award Date: Jan 1, 2011