Improving routine outpatient access to Magnetic Resonance Imaging (MRI) in an acute Dublin teaching Hospital

Aims - The aim of this quality improvement is to improve routine outpatient access to magnetic resonance imaging in an acute Dublin teaching hospital.

Rationale - The Hospital had recently commissioned a second Magnetic Resonance Imaging (MRI) scanner and although it had significantly improved inpatient access, outpatient access remained a serious concern. When data was collected, it was identified that for certain scan types (including spines and brain), the next routine appointment would be scheduled in excess of two years. A review of relevant literature identified that improving access was contingent on analysing capacity, activity and demand. This analysis would indicate the actions required to either decrease demand, increase capacity or improve activity. The restrictions of a limited budget and reduced staffing required that the department look at alternative ways of improving access. Therefore the focus was on increasing the activity through process improvement.

Change Process - The Senior and Swailes Organisational Development model for change was used as the framework for implementing the objectives set.

Evaluation and Results – The outcome of the evaluation indicated that the review of scheduling, the review of protocols and the validation of the waiting list all positively impacted in decreasing access times. The development of Key Performance Indicators against which to provide on-going evaluation and support for informed decision making was delayed by external factors.

Recommendations and Conclusion – As a result of the initiative it has become evident that in order to improve access to not only MRI, but to all diagnostic imaging, that the publication of national access targets is required.