Background

When the unit-based team members at the imaging department at L.A. Medical Center wanted to improve the turnaround time for X-rays and other diagnostic tests, they realized that they couldn't do it by themselves. They needed to take a systemic view and look at how their work interfaced with other departments—in this case, the Emergency Room and Transportation departments. Working together, the three departments applied the PDSA steps and have made changes that are creating distinct improvements.

Biggest challenge

Size and scope, said management co-lead Maillard. "We have three departments, all of whom have challenges of their own. We couldn't solve everything for everyone. We had to repeatedly bring ourselves back to our charter, and focus on what's going to improve our throughput, our original objectives. So focus has been the primary challenge, keeping our eye on the prize. And communication—because it's so big a team and we had to figure what message we want to get out to frontline workers."

What made it work: "The key is to really get a team together and target the areas that are problematic," said CT/MRI tech and labor co-lead Stewig. "We got together with the supervisors and lead techs and all put our two cents in. And we kept going back and forth, back and forth, until we all agreed."

Advice to other teams: "Try to stay focused and meet as often as possible," Maillard said. "We only have team meetings once a month, but because of the scope we huddle every week, sometimes we have little caucuses more often. If you only meet once or twice a month you won't keep the momentum going. A huddle can be spontaneous, just pulling people out to the hall for five minutes. Keep checking in and giving ongoing support."