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Work is under way to get patients in more quickly for Radiology visits

bulletin 09-07-23

A health system team is working to improve access to Radiology services by making it easier for patients to get appointments for different types of imaging, including mammograms. The Radiology initiative is part of Access 365, an effort to improve access to a wide variety of services across YNHHS.


This article is part of the Strengthening Our CORE news series that looks at how teams across Yale New Haven Health are working to reposition the health system for the future by focusing on strategic priorities through a systemwide initiative called Strengthening Our CORE (Collaboration, Optimization, Resiliency, Efficiency). Multiple workstreams have been designed to improve operational efficiencies; foster innovation; and improve quality and safety for patients and employees. Access 365, a major component of CORE, is dedicated specifically to providing patients with greater, more timely access to our services across the health system.

 

“Why does it take so long to get an MRI?”

“I called to schedule my mammogram and my appointment is five months out!”

“I have to travel almost 20 miles to get the soonest radiology appointment.”

Sound familiar? Yale New Haven Health leaders say they are well aware of the access problems across the enterprise for radiology, tests and procedures, and that patients often wait weeks or months for an appointment. 

A multi-disciplinary team is working to change that. The team includes frontline staff and managers, along with employees from Digital and Technology Solutions (formerly called ITS), Central Scheduling, Office of Strategy Management, the Joint Data Analytics Team and other departments.  

Increasing and improving access throughout the enterprise is the goal of Access 365, an initiative that aims to create a world-class experience for all consumers, including patients, providers, referring providers and staff members. One focus area this initiative supports is Radiology and access to appointments for imaging procedures. 

“We know that patients and providers are having trouble accessing our services,” acknowledged Daniel Alexa, executive director, Radiology Operations, YNHHS. “There are many variables to consider when making a radiology appointment, and we have been diligently working on strategies to get patients scheduled at the right time, in the right place and with the right exam.

“Simply put, the demand for many of our radiology services exceeds our capacity to perform them,” he said. “We have many talented people throughout the health system working to solve the problems, but we need to be universal in our approach in order to establish a standard Care Signature for ambulatory radiology services.”  

“Care Signature Pathways can help us reduce waste, ensure appropriate imaging requests and help clinicians assess the acuity of the need for imaging,” said Rob Goodman, MBBCh, radiologist-in-chief, Yale New Haven Health, and chair of Radiology and Biomedical Imaging, Yale School of Medicine. He and Alexa co-lead the Executive System Radiology Optimization Committee.

The current state of operations is not sustainable for the long term; and the health system is taking steps to address the issue by developing standardized templates, creating efficiencies and implementing technology to streamline access, Alexa said. YNHHS is putting several strategies in place to align the supply and demand of radiology imaging services. Plans include short-, middle- and long-term tactics.

“In the short term, we can increase efficiencies and decrease appointment times,” Alexa said. “A current initiative will standardize scheduling templates and decrease some MRI appointment lengths.

This will allow time for an extra two MRIs a day, per site, which can add up to 5,000 more MRI appointments per year across the health system. Work is also under way to automate appointment scheduling so patients can self-schedule more imaging exams online. This feature will launch in select areas in the weeks ahead.”  

Longer-term goals to improve workflow include expanding hours for radiology appointments; establishing a pipeline of talent to fill staff vacancies; and developing internal programs to train qualified individuals.

Alexa and Goodman emphasized that none of the work to improve access can succeed without the help and hard work of technologists, schedulers and other support staff at the heart of these processes. 

“It is important for our employees to know that all of the work they are supporting is appreciated,” Alexa said. “We thank them for their dedication to improve access to imaging exams.”

Implementing a few simple strategies has already yielded positive results, Alexa said. Sending reminders to patients about upcoming appointments has helped improve the “no-show” rate from below target to up to 15 percent above target. Work is under way to establish a waitlist to help fill cancellations.

In addition, the state of Connecticut recently approved YNHHS’ Certificate of Need request for additional MRI and CT scanners and PET CT machines. 

“Imaging touches every service line at the health system – so any improvement in imaging access directly impacts patient care,” Dr. Goodman said. “Yale New Haven Health provides quality radiology service to patients, and we look forward to being able to increase and improve access in the future.” 

Radiology is the first area to be featured for Access 365 work; watch for information on other areas and additional details.