Lessons learnt from quality improvement in radiological service : Four key factors for sucess

Sammanfattning: BackgroundIn this study, we describe a Quality Improvement (QI) intervention in three radiology departments within the Swedish health care system, with a special focus on access and methodology. AimThe goals for the QI-intervention were to implement best practice for patients with suspected colon cancer, and reduce the Turn Around Time (TAT).The aim of the study was to identify relevant factors for successful QI in order to further develop the organisation to create a system of continuous QI (CQI) for the radiological service. MethodsInitially, a multiprofessional QI-team was formed. To identify waste and areas for improvement, process mapping and lead time analysis were conducted during a collaborative learning approach. A focus group interview was carried out with the participants in the QI-intervention and the local managers, and a qualitative content analysis of the focus group transcript was performed. ResultsBest practise was gradually introduced, and overall access was improved, but TAT was not changed. Four key factors for CQI were revealed; Communication, Engagement, Context, and Patient- and Customer focus. Moreover, the impact of providing useful and reliable measurements to the frontline staff was found to be high DiscussionThe lack of decreased TAT indicates that further redesign of the radiology process is needed. As the impact of measurements was considered high, an improved system for obtaining and providing useful information to all parts in the organization is essential. Moreover, the infrastructure for CQI needs to be developed further, e.g. by clarifying roles, educating in improvement knowledge, and developing multiprofessional meetings. Finally, motivating and engaging staff is crucial to improve healthcare. It is important with a deeper understanding what triggers this, patient centeredness could be one.