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Quinte Mri Case Study

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Case Study 1: Quinte MRI

Module 4 - Session 3: Capacity, Process Flow and Bottlenecks II

Shayne MacKinnon

June 2, 2017

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Executive Summary                                Page 1

Issues Identification                                Page 2

Operating Environment                                Page 2

Root Cause Analysis                                Page 4

Alternatives and Options                                Page 6

Recommendations                                        Page 7

Implementation                                        Page 8

Monitor and Control                                Page 11


Case Study: Quinte MRI

Executive Summary

Quinte MRI Inc., is a service provider that specializes in medical diagnostic technologies to various hospitals and medical centers. They offer MRI (magnetic resonance imaging), nuclear medicine, ultrasound, CT (computerized tomography) scans, bone densitometry, mammography and teleradiology services. Quinte MRI’s founder Dr. Syed Haider first attempted to open a location in Belleville, Ontario, Canada but was unsuccessful due to “Canadian regulations prohibited private-sector MRI” so he opened facilities in the United States and the Caribbean.

Quinte MRI had three different client groups which are seeking to outsource their diagnostic imaging services. These include Physicians wanting to be partners in an independent diagnostic imagining centers, and individuals wanting to operate their own diagnostic imaging center using Quinte MRI as a consultant. From 1998 to 2001 there had been a significant increase in MRI procedures/scans and purchases, this resulted in Quinte MRI stepping in and providing services to hospitals, physicians, and individuals seeking to make MRI readily available to more people.

Quinte MRI provided their customers with a service to be able to use the MRI machines when they pleased, 24-hours a day/7 days a week. The Benton-Cooper Medical Center (BCMC) is a private non-profit community hospital seeking to switch their MRI service providers to be able to increase the number of days they currently operate the MRI machine to more than two days a week.

The BCMC was very interested in the availability that Dr. Haider had stated that they would provide for the MRI machine. As for the cost of the machine and someone to conduct the procedures Quinte MRI and BCMC would split the costs. Quinte MRI would own 100 percent of the MRI center and be responsible for most of the machines operation and management, while BCMC would be responsible for scheduling patients and paying the salaries and expenses of the radiologists.

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Issues Identification/Operating Environment

  • Poor communication between patients and the scheduling department
  • Patients are not being screened properly before coming to the MRI scan
  • Sinclair’s training on different MRI machines
  • Poor process design
  • Overloading of MR technologists

Quinte MRI’s leased machine is not meeting its expected output as projected and is now causing great concerns to both Quinte and BCMC. This caused them to lose revenue via referrals away from their clinic. BCMC’s reputation is also at risk now which could potentially result in further additional losses to the center.

Quinte MRI also faced many problems from operations to management. They were operating with only one person at the facility operating the machine on a weekly basis. This was causing major backlogs and bottlenecks and resulted in fewer patients being seen each day. Jeff Sinclair is the only MRI technologist who is scheduled to work 40 hours a week, Monday – Friday, 7:30 am to 4:30 pm. His day in the MR room starts off with warming up the machine for 30 minutes and patients cannot be seen at that time. In exhibit 7 we see that Mr. Sinclair is not meeting the rate that Dr. Haider had promised his operations would meet.

Environmental and Root Cause Analysis

The bottleneck and backlog is a major problem for both Quinte MRI Inc., and BCMC because Quinte MRI is unable to meet the standard times that they had set which causes a setback for the BCMC patients. Monica Zimmerman, manager of the radiology department, stated that she would like to hire another MR technician to alleviate some of the pressure faced by Mr. Sinclair and allow more patients to be seen.

Considering all of the issues Quinte and BCMC are facing, we can determine that the root cause is identified by the process not being fed properly, which is resulting in a low capacity. The scheduling must be re-assessed, and a new process must be put in place. The issues below are what is causing the most concern for the clinic.

Scheduling

Poor Communication

Excessive OT & Additional Cost

  • MRI scheduled for 1 MRI per hour and cannot reach that output, even though it was promised to reach capacity of 2 scans per hour
  • Other patients are scheduled in that should not be able to receive an MRI due to medical conditions
  • Scheduled department appointment form is not legible
  • Communication barrier between radiologists and the MRI technologist
  • Radiologist requires the images ASAP but the MRI tech can’t meet that expectation
  • Employees are working extremely long hours
  • The managers put too much pressure to add a second partial shift
  • Hiring another MRI tech would cost more money
  • They would also have to pay aprox. an additional $38 per hour plus their benefits

Back log of 14 days

Upset Patients

Loss of revenue & referrals

  • The back log has not exceeded the 14 day limitation and therefore are now providing poor quality service to patients
  • Wait times have exceeded and the overall process has cause a major bottleneck which is resulting in very poor customer satisfaction
  • Working concerns of BCMC’s sole MR technologist
  • Patients are being scheduled in for the wrong times
  • Patients are being screen incorrectly which causes major delays for the other patients
  • The revenue per scan is aprox $70,000
  • There is a major loss of patient referrals from doctors

Strengths

  • They are a growing business
  • Maintained a variety of exclusive partnership arrangements
  • Equipment is from many leading brands
  • Impressive capabilities
  • Haider’s integrity and personal attentiveness
  • Available 24/7
  • New machinery
  • One machine is capable of having 2 patients in at one time

Weaknesses

  • Scans are 45 minutes, therefore less than 2 patients can be scanned per hour
  • Hospital pays the radiologist and schedules the clinic
  • Only one technician who works too much over time – wanting to work less

Opportunities

  • MRI technology has become increasingly popular within the medical profession
  • The number of procedures are growing each year – meaning the number of scans go up as well
  • BCMB has relocated to a better location with doctors, hospital beds and over 20 specialists
  • Forecast anticipates a 15% increase yearly

Threats

  • MRI machines require a significant investment
  • The facility must require the space and equipment requires special shielding  from magnetic fields
  • There is a shortage of specialized MRI techs – especially in rural areas
  • Not many people are willing to work part time

Alternatives and Options

Creating a system in which they patients can have more access to making, cancelling and rescheduling could reduce the amount of patients not seen throughout the day. When patients cancel or arrive late, it pushes back other people on the list and causes major delays – not to mention frustration for both the patients and technicians. Some patients may be sitting and waiting very long periods of time, and potentially not even being able to get to their appointment on the day they scheduled.

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