Brenton-Cooper Medical Centre (BCMC) has outsourced its MRI operations to Quinte MRI, a seasoned and highly recognized MRI service provider. Unfortunately, after six weeks of operations Quinte MRI’s leased MRI machine is not meeting its expected outputs as projected and is causing concern to both Quinte MRI and BCMC which has begun to lose revenue via referrals away from its clinic. Further, BCMC’s reputation is now at risk which could result in additional loses to the centre. The root cause of the problem appears to lie with the scheduling of the scanning operations.
Dr. Syed Haider, the owner of Quinte MRI, has tasked his business development coordinators with finding a solution to this problem and to report back within 2-days.
Acting as David Wright and Kevin Saskiw, the business development coordinators, my solution to these issues are to regain control of the scheduling process as this is an integral part of the operations. Streamline the scheduling process to reduce variability and improve reliability. Introduce the use of technology to remove manual processes, improve process efficiencies, minimise errors and improve communication across the business lines of operation. I would also hire a new employee to support the scanning operations as there is no backup or adequately trained support for the only Technologist running the operations.
Brenton-Cooper Medical Centre (BCMC) has outsourced its MRI operations to Quinte MRI, a seasoned and highly recognized MRI service provider. Unfortunately, after six weeks of operations Quinte MRI has not lived up to expectations and is not fulfilling its contractual obligations.
Quinte MRI’s leased MRI machine is not meeting its expected outputs as projected and is causing concern to both Quinte MRI and BCMC which has begun to lose revenue via referrals away from its clinic. Further, BCMC’s reputation is now at risk which could result in additional loses to the centre.
Quinte MRI is well aware of this as it stands to lose in both areas as well. If the firm cannot meets its contractual obligations and have its leased machine produce its expected output the loss of revenue would surely spell business failure and a subsequent loss of reputation. As well, the firm would probably be sued for breach of contract.
On another level Quinte MRI has also identified potential issues with a stressed out, overworked employee whom is critical to the success of their business. Potentially, this employee could actually be one of the reasons of the problem that the firm is experiencing. He has identified issues surrounding the scheduling of patients for scanning and has indicated that the process needs to be fixed as it is not working. He further went on to indicate that the expectations from the radiologist for speedy delivery cannot be met due to the time it takes for him to process the patients’ MRI films.
Environmental and Root Cause Analysis
In my opinion there are several operational issues causing problems in the MRI scanning process. First, I believe that there is a problem with the scheduling of patients in that it lacks accuracy, consistency and clarity. Since this operation is being handled by BCMC, Quinte MRI is finding itself at a disadvantage in terms of being able to control this part of the operation. The operation appears to be purely manual, handled by several persons and is prone to input and interpretive errors. Since patients can be sent for scanning via two means (scheduled and same day(unscheduled)) some amount of variability will result. It is therefore imperative that the scheduling function be properly controlled and managed to reduce variability to minimum possible levels. Variability and uncertainty in the scheduling operation is negatively impacting capacity utilization resulting in an overall reduction of efficiency in the scanning process.
Quinte MRI must balance the flow and increase capacity for greater efficiencies and to remain competitive. The bottleneck of the scanning process is the MRI machine and the time it takes to do each scan. Each scan may have different times associated with it depending on the type to be performed, limiting the capacity of the overall process. Each step in the scanning process is dependent upon the previous one therefore improvements need to start at the beginning. The objective here is to improve the process flow up to the point that the actual scan will take place.
I also believe that patients are not being properly screened prior to arrival which is causing Quinte MRI losses in revenue and time. If a patient turns up and has to be turned away, or rescheduled for misdiagnosis there is a resulting disruption in the flow of patients which will impact the schedule and process and ultimately the pocket and reputation of the company. Further, it appears that the technologist is engaged in performing pre-screening services and this is a highly paid employee who should not be pre-screening patients. This tasked could best be left to a lower paid trained staff.
From an operational perspective it appears that the initial implementation process of the new machine had a learning curve. This resulted in longer lead times for processing patients during the first few weeks until Jeff had found a rhythm. It appears that Jeff was either not properly trained or did not have sufficient experience in the use of that model machine.
Communication, and barriers to, seems to be a fundamental problem in the whole scanning process. People and processes are not talking to each other in an efficient and effective manner. The patients are unsure of the process and what is expected of them resulting in missed dates, tardiness, improper attire, rescheduling, lost revenue, lack of confidence, etc. Responsibilities appear not to be clearly defined, or assigned, leading to inefficiencies in the process. As well, expectations of persons are not clearly defined and communicated ahead of time leading to missed schedules, frustrations and delays.
Alternative and Options
In my opinion Quinte MRI could request the transfer of the responsibilities of the scheduling process over to their firm. This could benefit the firm in that they would now have ultimate control of the scheduling process from start to finish. As it is the firm has to rely on BCMC to manage this function and this is causing many issues.
I believe that an MR Technician could be hired to perform the scheduling tasks and also provide support to Jeff Sinclair. Quinte MRI is already paying for these services but not receiving value. Revenue loss from turn-aways alone (1.2 p/day) could adequately cover the costs of hiring someone to provide these services.
Additional benefit would be backup support for Jeff during vacation or other away days. Training would be provided on the job to support Jeff and add additional new skills to the technician. Screening could be done well ahead of time before the patient arrives because someone with the knowledge and expertise is handling this.
Quinte MRI could invest some capital in technology to support the scheduling and communication functions. The technology would be able to support scheduling combinations for more efficient processing of patients in the scanning process. Many persons (from BCMC and Quinte MRI) could have visibility into the system with relevant authority to administer or make changes. This technology would be able to eliminate some amount of confusion and errors based on interpretation as is currently happening. Savings from a smooth flowing process with no disruptions would easily cover upfront costs as well as any operating costs.
Courtney from Study Moose
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