The immediate issue is that Benton-Cooper Medical Centre’s MRI clinic has been open for 6 weeks and not performing to expectations and to the promises made by their new MRI provider, Quinte MRI. With referrals to the clinic, doctors expect to receive MRI transcription reports within two days and the current backlog exceeds 14 days. As a result there is a loss of patient referrals from doctors within the hospital and surrounding community which means a loss of revenue for BCMC. Quinte MRI must determine what is causing the backlog and how to fix it. Secondary Issues
A secondary issue in the clinic is that the MR Technologist is putting in a lot of overtime even though the maximum number of patients each week is not being met. Quinte MRI personnel need to examine and analyze the interaction between the capacity, the process flow and the bottleneck and provide a resolution and action plan back to the CEO, Dr. Syed Haider within 2 days.
Environmental and Root Causes
Quinte MRI, an international service provider specializing in medical diagnostic technologies signed an agreement in February 2002 with Benton-Cooper Medical Centre (BCMC) for the outsourcing of their MRI services. BCMC believed that they could competed successfully if they had a third MRI machine as they anticipated continued growth in this area by 15% through doctor’s referrals from the hospital and surrounding areas. BCMC also believed that they could generate enough revenue and promotional support through advertisements with local print and radio stations to be able to own their own fixed MR system and be recognized as a top rated hospital for the area. Quinte MRI promised the avenue for BCMC to be able to accomplish these goals through its service reliability and access to diagnostic equipment 24 hours a day, 7 days a week at a reasonable cost. However, these expectations are not being met and David Wright has gone to the MR Technologist, Jeff Sinclair to examine and analyze what was causing the backlog (bottleneck) in the operation. Jeff indicated that due to poor communication between the hospital and the clinic, mistakes were being made due to a manual process for recording information. Patients were being booked at wrong time, cancelling or not showing up, wrong tests were being requested or recorded, and patients were not being screened properly for an MRI scan. An assessment was being done when the patient came into the clinic. A patient preparation process has not been implemented in the new facility, whereas the previous MRI provider scheduled all appointments. Jeff felt that wasted time was being spent on delivering scans to the radiologist after each patient. Jeff also accounted for the fact that during May, the clinic used a Siemens unit, which took some time to get used to, however, now that the GE machine was in place (Jeff was originally trained on this machine), things were improving. David next examined the cycle time on for a 30 minute procedure. The table below shows the current cycle time of the patient, the MR Technologist and the MRI machine. 15 minutes was dedicated to patient preparation for an MRI while only 27.5 minutes was spent in the Magnet Room. 42.5 minutes was being spent on a 30 minute procedure. This was where the bottleneck was in the process. Staying with this current process and resources, the maximum capacity of this process can only be 8 procedures if all other inputs into this process ran smoothly (i.e. no cancellations). Exhibit 1
Patient Check in until entrance into Magnet Room Minutes MR Technologist escorted the patient to the Magnet Room
(asks questions to determine if any health risks/conflicts and if any patient has any metal components internally or on clothing) 59Patient – 42.5 minutesMR Technologist – 42.5 minutes Changing Room for patients wearing metal on their clothing
(25% of patients)4