Abstract：
OBJECTIVE: Breast imaging services often experience a significant degree of variability in patient flow, leading to delay in time to diagnostic resolution, commonly referred to as time to resolution (TTR). This study applies Lean Six Sigma Methodology (LSSM) to reduce TTR and enhance patient outcomes.
METHODS: This study was IRB-approved. A baseline audit was done using cases of mammographic recalls (BI-RADS 0) to measure baseline TTR. Multidisciplinary meetings with all members of the breast imaging service, alongside a study of patient complaint data, were utilized to identify issues that were causing prolonged TTR. Following that, possible solutions were proposed and implemented. A post-implementation audit was conducted, and the resulting TTRs were compared. Significant differences in TTR between the pre- and post-solution implementation were assessed using the Mann-Whitney U test.
RESULTS: During the baseline audit of 8 months, 589 cases of mammographic recalls (BI-RADS 0) were identified, and the resulting average TTR was 86.3 days. During the post-implementation period of 3 months, 370 mammographic recalls (BI-RADS 0) occurred, with a resulting average TTR of 36.0 days. After applying LSSM, TTR was reduced by 58.3% (P < 0.01). Some changes implemented included training the coordinators, establishing a rapid diagnostic clinic using previously underutilized equipment, and having radiologists assigned full-time to the breast imaging service.
CONCLUSIONS: Our team has successfully managed to identify various causes behind the prolonged TTR using LSSM. Team collaboration was essential to study and decide on a more achievable TTR.
METHODS: This study was IRB-approved. A baseline audit was done using cases of mammographic recalls (BI-RADS 0) to measure baseline TTR. Multidisciplinary meetings with all members of the breast imaging service, alongside a study of patient complaint data, were utilized to identify issues that were causing prolonged TTR. Following that, possible solutions were proposed and implemented. A post-implementation audit was conducted, and the resulting TTRs were compared. Significant differences in TTR between the pre- and post-solution implementation were assessed using the Mann-Whitney U test.
RESULTS: During the baseline audit of 8 months, 589 cases of mammographic recalls (BI-RADS 0) were identified, and the resulting average TTR was 86.3 days. During the post-implementation period of 3 months, 370 mammographic recalls (BI-RADS 0) occurred, with a resulting average TTR of 36.0 days. After applying LSSM, TTR was reduced by 58.3% (P < 0.01). Some changes implemented included training the coordinators, establishing a rapid diagnostic clinic using previously underutilized equipment, and having radiologists assigned full-time to the breast imaging service.
CONCLUSIONS: Our team has successfully managed to identify various causes behind the prolonged TTR using LSSM. Team collaboration was essential to study and decide on a more achievable TTR.
摘要：
目的：乳腺影像服务通常会经历患者流量的显着变化，导致诊断解决方案的时间延迟，通常称为时间解决（TTR）。本研究采用精益六西格玛方法学（LSSM）来降低TTR并提高患者预后。
方法：本研究获得IRB批准。使用乳房X线照相召回（BI-RADS0）进行基线审核以测量基线TTR。与乳房成像服务的所有成员举行多学科会议，除了对患者投诉数据的研究，用于识别导致TTR延长的问题。在此之后,提出并实施了可能的解决方案。进行了实施后审计,并比较了所得的TTRs。使用Mann-WhitneyU检验评估溶液实施前后TTR的显著差异。
结果：在8个月的基线审核中，589例乳房X线摄影召回（BI-RADS0）被确定，平均TTR为86.3天。在3个月的实施后期间，发生了370次乳房X光检查召回（BI-RADS0），结果平均TTR为36.0天。应用LSSM后，TTR降低58.3%(P<0.01)。实施的一些变化包括培训协调员，使用以前未充分利用的设备建立快速诊断诊所，并让放射科医生全职分配给乳房成像服务。
结论：我们的团队已经成功地设法确定了使用LSSM延长TTR的各种原因。团队协作对于研究和决定更可实现的TTR至关重要。
方法：本研究获得IRB批准。使用乳房X线照相召回（BI-RADS0）进行基线审核以测量基线TTR。与乳房成像服务的所有成员举行多学科会议，除了对患者投诉数据的研究，用于识别导致TTR延长的问题。在此之后,提出并实施了可能的解决方案。进行了实施后审计,并比较了所得的TTRs。使用Mann-WhitneyU检验评估溶液实施前后TTR的显著差异。
结果：在8个月的基线审核中，589例乳房X线摄影召回（BI-RADS0）被确定，平均TTR为86.3天。在3个月的实施后期间，发生了370次乳房X光检查召回（BI-RADS0），结果平均TTR为36.0天。应用LSSM后，TTR降低58.3%(P<0.01)。实施的一些变化包括培训协调员，使用以前未充分利用的设备建立快速诊断诊所，并让放射科医生全职分配给乳房成像服务。
结论：我们的团队已经成功地设法确定了使用LSSM延长TTR的各种原因。团队协作对于研究和决定更可实现的TTR至关重要。
