Quartz 4

Story of hot reporting intiative at NDDH

2 min read

Title - Story of hot reporting intiative at NDDH Tags - callumstory

  • Problem: huge waiting times in ED
  • Inefficient process for minor injuries
  • See triage nurse

  • See doctor

  • Refer for x-ray

  • Wait for

  • Have x-ray

  • Wait for ED clinician to review

  • Wait for ED clinician to give results

  • Treatment or discharge

  • Reported by radiologist days later

  • Error? Patient contacted
  • Hot reporting system
  • See triage nurse

  • Refer for x-ray

  • Wait for x-ray

  • Have x-ray

  • X-ray reviewed by reporting radiographer immediately

  • If normal, radiographer discharges

  • If abnormal, referred to ED clinician with results ready
  • Benefits of hot reporting
  • Much faster care for patients

  • Reduces demand on ED nurses and doctors

  • Reduces wait times for all ED patients

  • Fewer diagnostic errors

  • Better outcomes (as result of fewer errors) for patients

  • Cost savings for NHS

  •     Reporting radiographer salary much lower than radiologist

  •     Process efficiency savings

  •     Reduction in penalties for ED patients exceeding max wait times
  • Went to pioneering hospital in Yorkshire to study process
  • Came back and introduced to managers
  • “Too pioneering for North Devon”
  • Translation: it will disrupt hierarchical culture for radiographers’ to report and radiologists “fear for their jobs”
  • I got frustrated and left the job and career
  • Eventually, they did train 2 reporting radiographers
  • Never implemented hot reporting or radiographer-led discharge in ED
  • Reporting rads barely utilised, have to “justify” pay with managerial duties which dominates their time
  • At the same time, waiting lists for x-ray reporting increasing
  • ED wait times, penalties, quality, efficiency all getting worse
  • Reporting outsourced for huge fees
  • Reporting by outsources company done by radiographers!

  1. Frustration, tragedy, some trigger sends person on quest

  2. … for a clear object of desire (shared by audience)

  3. Risk, struggle, conflict

  4. Triumph

Purposes:

  • to demonstrate opportunity for process/system improvement in business
  • to demonstrate foolishness of “because this is how we’ve always done it”

Graph View