Increasing Profitability in 19 Imaging Centers

Situation

The client’s nineteen medical imaging facilities had a 50% market share within their state. Originally formed from a merger of four large physician-owned facilities, the company also works closely with a leading medical school and associated hospital group.

Subsequently purchased by a private equity (PE) group, the management must now meet specific financial goals.

Management and staff stated at the start that the facility was running at world-class levels. They believed that the PE group’s goals were unrealistic and indicated a lack of industry knowledge.

Services provided include Magnetic Resonance Imaging (MRI), Cat Scan (CT), Positron Emission Tomography (PET), Nuclear Medicine, Dual Energy X-ray Absorption (DEXA), Ultrasound, Mammography, Fluoroscopy, and X-ray.

Within facilities, significant variations in work practices were noted among departments and  shifts. No effective supervisory coaching was done, and the few training sessions were classroom-based.

Documentation of processes and productivity varied by individual supervisors and departments.

Coordination of  training among facilities was done informally and based on personal relationships. Some cross-fertilization of ideas occurred due to some staff working part-time at multiple locations.


Opportunity

During primetime hours all MRI time slots were booked. No shows were common. Managers could not provide meaningful plan versus actual usage information by time slot by day. Staffing was assigned based on seasonal averages.

Rooms with imaging equipment would be used for preparing patients, thus letting the expensive equipment sit idle.

Radiologist staffing levels and timing were not driven by facility and modality usage. Delays in reading results caused patients to have to return for subsequent imaging but without the ability to charge insurers for the additional work.

Call center employees were incompletely prepared for the many types of calls received. With varying backgrounds and training, their responsiveness to customer needs also varied. Staffing levels were near-constant while call volumes varied significantly by day and by the hour.


Approach

Four operational teams were formed. These teams consisted of management, individual performers, and consultants. Consultants added project management skills and expertise in developing analytics as needed.

All teams reported progress weekly in developing process improvements and associated tools.

The teams mapped current processes and weaknesses. Process improvements were identified and implemented with no change to IT systems. Process metrics were developed for supervisors to identify deviances during each shift. Team members led training and on-the-floor coaching of supervisors and key personnel.

Operational teams were supported by “Staff Teams” for topics including organizational communication, change management, training materials, and metrics.

Weekly metrics maintained by client finance group objectively identified progress and savings. Operational and financial metrics were reviewed weekly by operational management and biweekly by the executive team.


Results

$3.5 million was added annually to the client’s bottom line. The project achieved its payback rate of three to one.

Closed MRI utilization increased by 15%. Scheduling was modified to allow for analytically-driven overbooking. No shows were decreased through pre-visit confirmation calls and patient travel assistance. Repeat imaging exams were reduced by adjusting radiologist staffing levels to equipment utilization.

Overall, work hours were reduced by having patient and call volumes drive staffing levels in facilities and the call center.

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