MRI in the NHS,Malta: The effectiveness of a radiographer led unit' - PowerPoint PPT Presentation

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MRI in the NHS,Malta: The effectiveness of a radiographer led unit'

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169,146 Imaging studies in 2006. MDH fully ... 1 Principal Radiographer and 15 Radiographers rotating daily. 5 Consultant Radiologists vetting all requests. ... – PowerPoint PPT presentation

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Title: MRI in the NHS,Malta: The effectiveness of a radiographer led unit'


1
MRI in the NHS,Malta The effectiveness of a
radiographer led unit.
  • Joseph Castillo B.Sc, M.Sc (HCM), M.Sc(MRI)
  • St. Lukes/Mater Dei Hospital

2
Brief outline of SLH/MDH
  • 500 bed hospital
  • 1000 employees
  • 169,146 Imaging studies in 2006
  • MDH fully digital

3
The first five years
  • 1 Principal Radiographer and 15 Radiographers
    rotating daily
  • 5 Consultant Radiologists vetting all requests.
  • All IV contrast injections done by Senior
    Radiologists or Doctors.

4
And the result was…
  • 2 month delay to send appointments.
  • Lack of ownership, accountability and motivation.
  • Patient throughput delays waiting to inject.
  • Structural idle time
  • Radiographers do thing as they know rather than
    the new way.
  • All this leading to….

5
  • A waiting list of 8 months in August,2006
  • Increased pressure from physicians who did not
    want their patients to wait that long.

6
Proposed Change
  • 2005 Upgrade to GE Twin Speed/Asset.
  • Optimize Protocol to answer clinical question
    rather than routine scanning.
  • Team with specialist radiographers MRI and
    Sound Clinical Background.
  • Team challenge started September 2006.

7
Other measures
  • Eliminate Saturdays (730 100pm)
  • Introduce 15min overlap between shifts.
  • Maximize patient transportation.

8
Role Development
  • All Radiographers specialized in all aspects of
    MR Imaging.
  • All request forms vetted first by Radiographers
  • Educate junior doctors on different MR protocols.
  • IV injection done by Radiographers.
  • Indirect reporting.

9
One Great Team (OGT)
  • People are working together
  • Positive attitude pervades
  • People have control over their work environment
    (sharing monkeys).
  • Flexibility (very important in a small team)
  • Cooperation is the norm.
  • Attendance is high.
  • Pride is abundant.
  • The unit is highly respected and technically
    superior
  • Think Giraffe!

10
And now the results are…
  • Appointments send within 1 week.
  • Radiographers have ownership of all events
    happening in MRI. Satisfaction.
  • No delays in exams requiring gadolinium injection
  • Increased overall physician experience.
  • Contributing towards patients outcome.
  • And….

11
  • In September 2007 waiting list has been reduced
    to 2 months (9weeks).
  • Therefore increased overall patient
    satisfaction
  • And Pressure from physicians over elective
    requests eliminated.

12
Conclusion
  • Our initial observation indicates
  • 1. increased efficiency
  • 2. no reduction in patient safety
  • 3. Some inevitable increase in on-call costs.
  • 4. Maximized Radiographers Role in clinical
    outcomes.
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