Delivery of services to a patient has to be given with an acceptable measure of quality that can be monitored through the patient's satisfaction. The objective of this work was to innovate processes eliminating waste and non value-added work in processes done at the Imaging Department in the National Institute of Respiratory Diseases (INER for its Spanish acronym) in Mexico City, to decrease the time a patient spends in a study and increase satisfaction. This innovation will be done using Lean Six Sigma tools and applied in a pilot program.

No abstract

The impact within a known process due to the introduction of new technology may entail many factors such as workflow modification, increase of wait time, modification in service quality, and even cultural changes. The inclusion of these factors into a process affects its performance, but the implementation of innovations may counteract the impact and could even enhance the process. The objective of this work was to evaluate the impact of the innovations implemented in the X Ray process by the estimation of the learning curves and the estimated time in which the maximum learning may be reached.

The National Institute of Respiratory Diseases is a third level public hospital in Mexico City, which in 2007 acquired an RIS-PACS to be implemented at its Imaging Department (ID), with the objective to enhance its service. This department attends an average of 3,500 patients per month developing different image modalities. The objective of this work was to determine the overall sigma level performance of four processes of the ID: reception, X-ray, computed tomography, and radiologist diagnosis, considering process analysis and innovation through Six Sigma methodology, measuring the innovation effectiveness by means of indicators and learning curves. Initially, a first measurement (M 1) of the original processes was determined; once 13 innovations were implemented in a pilot program, two more measurements were done, 15 days after (M 2) and 30 days after (M 3), in order to know the impact of the innovations in the ID processes. The initial sigma level of the ID before innovations was σ 1 = 2.0, which means that there were 36 patients per day with a process defect during their stay at the ID. In the two following measurements, σ 2 = 2.2 which means that there were 28 patients per day with a process defect, and σ 3 = 2.3 with 24 patients per day with a process defect. These results demonstrate that the percentage of performance enhancement between the original process and 15 days later was 23 % and 30 days later an enhancement of 15 %. In total, an overall enhancement of 38 % was obtained at the ID of the institute.

Countries receptive to technology are those who absorb and adapt knowledge coming from developed countries. Their capability for assimilating technology depends on factors related with the availability of facilities, financial resources and even, cultural differences. In order to prevent adverse events in the usage of the technology, it is important to analyze and to evaluate these factors. The objective of this work was to identify and to analyze the elements involved in the performance and use of a PACS, and to provide a guideline for its implementation in healthcare systems of countries receptive to technology based on the use of PACS in Mexico.