Improvement story: From problem-solving class to implementation in interventional radiology

When Jenni Annarino, clerical supervisor in radiology, originally signed up to take the Quality Department’s Practicing Healthcare Improvement course, she wasn’t even sure she wanted to bring a problem to class. She was only six months into her leadership role and was grappling with where and how to start making improvements. Despite her reservations, she agreed to dive in and bring a problem her area was facing.

What started out as a very broad problem was scoped down to an actionable issue to solve: “Multiple communication platforms were being used among internal Interventional Radiology (IR) staff for scheduling requests and follow-ups.” Because of this, IR schedulers were having a hard time navigating the multiple platforms to know which patients or procedures they needed to prioritize. They were left feeling scattered and unorganized. Workflows were not consistent among different types of providers, making training and learning for new clerical staff increasingly difficult.

When Annarino joined the Practicing Healthcare Improvement course as a problem owner, she was grouped with three other participants from three different departments, all with varying roles, as well as a continuous improvement specialist who coached and facilitated the group’s A3 problem-solving efforts. Having these “fresh eyes” can be invaluable in problem-solving efforts.

Over the course of four two-hour sessions on two consecutive days in May, Annarino and her group mapped the current situation, developed targets, examined root causes and identified recommendations. Coach Patti Craig noted that she saw Annarino’s confidence grow throughout the class. And indeed, Annarino took the work they did in class back to her department to consult with the clerks and leadership prior to making any process changes.

As Tom Frederick, the Practicing Healthcare Improvement course lead, said, “we want to be careful about implementing solutions and executing ideas before getting input from all the stakeholders in the process.  It is great when the people who do the work participate in (and lead) the problem solving.”

Annarino also credited Carly Davis, an embedded continuous improvement specialist, with helping move the department forward by initiating department forums and presenting information. They also sent out guides and tip sheets to help ease the transition. 

Davis commented, “Using the A3 problem-solving process helped build the case for change and gain stakeholder engagement. Having a lack of standard in this area really impacted burnout. As we are making these positive changes, Jenni’s team feels like they have an advocate on their side.”

The target established in class was “By Oct. 1, achieve zero IR Scheduling Requests through Outlook.” And Annarino reported on Sept. 10, that “Interventional Radiology has had tremendous improvement with the issue I presented and troubleshooted with my classmates in this course. We are at almost 100% compliance with internal providers utilizing the MiChart inbasket workflow to communicate requests to the scheduling team.”

Having made these changes, Annarino is starting to see the ripple effect on other issues, saying, “We now have a lot of inbasket messages! We will need to fine-tune the new system. I don’t perceive an end to changes and that’s okay. We just want to keep making improvements. Everyone knew change needed to happen, but there were roadblocks. Seeing actual change being implemented is really encouraging. Our team knows that our leaders want to make things better, which ultimately, will be beneficial to our patients.”

Davis concluded,“Because of this work and learned skillset, Interventional Radiology has taken on multiple process improvement efforts that are aimed at improving clinical operations and patient care.”

Congratulations to the Interventional Radiology team for their continuous improvement efforts!

For more information on the Continuous Improvement courses offered in the Quality Department, visit the Quality Training Pathway page.