This is an analysis of the workflow between a hospital's Ambulatory Surgical Unit (ASU) and its Radiology Department

1. ASU and Radiology
A Process Overview
Michael Floriani
4/26/2010

2. Objective
The objective of this document is to identify key stakeholders and processes associated with the
“current state” handoff of patients between the Ambulatory Surgical Unit (ASU) and Radiology
departments at Paoli Hospital.
The goal for this endeavor is to identify areas for potential improvement and to ensure patients are
prepared and ready for Interventional Radiology procedures by a defined timeframe established by
management. This timeframe, as of this document preparation, is 8:00 AM.
“Current State” Process Flow
Referring to the above flow diagram as reviewed with the Director of ASU and Director of Radiology,
certain procedural changes were made during the initial plan to identify “current state” processes across
identified stakeholders. These changes are reflected within the above diagram and have led to some
process improvements. These are identified within the following respective areas below.
Radiology
Radiology receives requests for procedures and completes associated orders and patient information
within one week of the patient’s procedure. It is uncertain if this process requires a prior patient record
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3. to exist in the hospital’s patient database and may be an area for further investigation. Information is
transferred to registration for preregistration.
Upon completion of procedure(s), the patient is transported to ASU for post-operative recovery and
then discharged when appropriate. High risk patients who may require extended hospital stays have
not been documented in this process.
ASU
At the time of patient arrival, the patient is prepped and any necessary blood work is completed.
Illustrated on the flow diagram, either the lab or ASU can complete this. Upon review of these results,
the patient is ready for transportation to Radiology. As of this writing, there is no process other than
verbal communication on the patient status unless prior understanding of having the patient to
Radiology at a specified time. Furthermore, ORSOS could be utilized and management was attempting
to secure system rights from the Director of Nursing to facilitate communication of patient status using
this system.
CONCLUSION & RECOMMENDATIONS
Coordination of communication has occurred between ASU and Radiology since initial discussions were
originally undertaken to explore areas for process improvement. This open communication and
cooperation is very important in providing a more efficient and patient-centered experience and has
improved patient arrival to Radiology by the goal time of 8:00. Any handoff between patients increases
the chances for errors and all appropriate handoff protocols are required.
The following areas may require further investigation, depending upon current processes.
1. The coordination of patient information may require further investigation. If Radiology can
enter orders without prior patient data, this would not be an issue; however, if Radiology cannot
process orders without Registration first entering data, this would be function to potentially
consolidate within one department.
2. Transferring medical information is another area requiring a streamlined process, especially if
this requires hand-carrying information to Registration.
3. Blood work, if required, should be determined immediately upon patient arrival so that this
process does not delay transporting the patient to Radiology.
4. Coordination of a bed of high risk patients may require further investigation to ensure minimal
patient delay at time of post-operative recovery.
5. ORSOS should be utilized to facilitate inter-department communication of patient status.
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