The Executive team invited Meridian in to the Trust to conduct an analysis with the aim to propose an improvement programme within Theatres, Outpatients & Radiology. Their aim was to understand what their current utilisation was within these respective areas and understand the potential opportunity in financial terms.
The Trust had a planned spend of circa £2 million on additional sessions on top of their substantive PA sessions.
The analysis was a three-week long study, with a total of 35 days being used. The historic performance and management control systems showed a lack of control of planned and actual activity, expectation and performance.
The programme sold was a 32-week improvement programme.
The overall goals of the project were as follows.
- Clear definitions of additional hours, including Bank, Agency and Overtime (including Waiting List Initiatives and other additional sessions). Suitable controls implemented in all areas.
- Clear mapping of areas of responsibility and hierarchy to establish clear reporting lines and responsible parties – to include 6-4-2 planning
- Job Plans and templates defined and agreed, in line with 85%expectation for utilisation, with clear expectations supporting the creation of a detailed resource plan within each centre for elective procedures.
- Process flow mapping designed and agreed – From Wards and Day Case, ensuring full use of available systems and planners to ensure efficient flow for theatres
- Capacity & demand modelling implemented to create an agreed resource load covering all specialties.
- Service remodelling following from capacity, demand planning. Right resources defined for each theatre, taskbased resourcing in-line with AfPP.
- Resources reallocated to correct areas with additional resources being deployed to identified areas of need.
Meridian worked with the all staff within Theatres, Outpatients & Radiology through a series of interactions, consisting of workshops and individual sessions. During these various sessions, old practices and historic performance were challenged.
The processes implemented within Theatres, Outpatients & Radiology was aimed at streamlining process, raising utilisation and addressing any variances that occur within these departments that are affecting utilisation and the patient throughput within each department.
The main results of the programme are:
- Through new productivity targets, there is now an annualised Savings Realisation Plan in place for Theatres totalling £673,247.
- Achieved savings within Theatres, through reducing the number of Waiting List Initiatives monthly to the value of £42,522, which annualised is £510,264
- Through new productivity targets, there is now an annualised Savings Realisation Plan in place for Outpatients totalling £463,597.
- Raised the utilisation of available slots to the value of £54,549 monthly, which when annualised is £654,588. There is a further potential of £900,692 of income to be generated on an annualised basis
- Through new productivity targets, there is now an annualised Savings Realisation Plan in place for Radiology totalling £145,462.
- Structured planning process for theatre lists is now in place, allowing centre co-ordinators to review planned theatre lists and take appropriate action.
- A refined booking process focussed on booking short notice un-booked slots is resulting in 470 additional patients seen per month.
- Developed and installed a process for reviewing capacity & demand by modality based on current Job Plans, ensuring actions are taken to minimise variances.
- Developed, trialled and agreed an implementation plan for a ‘Duty Radiologist’, which will aid utilisation within Radiology and provide a focal point for queries within the department.