Establishing better workflow with an MR dashboard

September 22, 2020
by Sean Ruck, Contributing Editor
High-quality patient care is the driver for any hospital, but the nuances in how each hospital or healthcare organization goes about providing that care are numerous. The challenge is also to stay profitable while caring for patients. Any organization not meeting those two main tenets — good patient care and profitability — probably doesn’t have a long-term future. This is especially true today, where patient experience ties to reimbursement. While maybe not as damaging as a bad Yelp review might be for a local eatery, in the current healthcare climate with ever-thinning profit margins, anything a hospital can do to improve patient experience is likely to get a good look from leadership. And in situations where a department can increase throughput and decrease patient wait time, the possibility of increasing profitability and patient satisfaction is waiting close by.

Healthcare has a variety of tools to help meet those needs, but in some cases, such as those where the tools don’t exist or what’s available doesn’t quite fit the bill, innovative healthcare professionals figure things out on their own. That was the case at Johns Hopkins, where MRI manager Michelle Casler and Pediatric Radiology manager Samantha Mueller led the charge to create an MR dashboard.

According to Casler, in simple terms, the dashboard is an interface that is used to document delays for MR orders. It provides a way to document the delays and to gather data regarding those delays.

Samantha Mueller
“It lives throughout the entire process of the MR order,” explained Mueller. “It’s like a tracking system that helps us document conversations. When an MR order is placed on the unit, it goes to our radiology information system where we do all of our work. The dashboard is another application we log into that gets a feed from our RIS and mirrors that same order list and as the technologists contact the unit to work that order, to get the information about the patient, get the patient scheduled and bring them down, they use the dashboard to document those communications and potential delays. For example, a patient is ordered for an MR. They call to schedule the patient, but the patient needs an MRI screening form because they’re not alert and oriented, they can’t answer their medical history themselves. So that would be documented in the dashboard that we’re waiting for a screening form.”

The development of the dashboard started at the end of 2016 and it was rolled out for use toward the end of 2018. It was created because the department wanted a mechanism to collect data about their MRs and what delays were occurring in order to share with other departments and management what the biggest barriers were to MR workflow. Prior to the dashboard, that information was somewhat ethereal.
“A lot of the process we were experiencing was verbal or manual, so it wasn’t something that was captured in the information systems we were already using,” said Mueller.

The two had their suspicions about where slowdowns and barriers were, but the information they gathered allowed them to present the information as solid facts. Some of the most useful data weren’t just about showing the barriers, but allowed for trending the slowdowns in order to more clearly address the problems and get additional resources during times of need.

Michelle Casler
“I would say it also helps us gain targeted information,” said Casler. “We’re able to see what trends exist and use this information to target education on certain units or with certain providers or groups. The data drives decision making, and helps guide policies and procedures, to make the most positive impact on patient care and throughput.”

Casler says that in part, thanks to the two-year development process, the majority of changes and tweaks for the dashboard were made before rollout. Still, she anticipates that updates and changes will be in the mix for the future as new and additional needs are identified.

Mueller offered advice for other professionals looking to introduce their own MR dashboard. “Make sure you define your data elements from the beginning and that everyone is speaking that same language. From a radiology perspective, an MR order, an MR patient, an MR encounter means something very different for someone working in, let’s say for example, ambulatory data. We didn’t necessarily have all of that laid out up front. We had to circle back when we got to the data to iron some of that out. The other thing is that it’s a huge collaboration between clinical and IT people, software developers and data analysts — so making sure you have the right stakeholders at the table is really important.”