Imaging Operations Improvement

The Queen’s Health System (QHS) is a nonprofit private healthcare organization that serves the Hawaiian community. QHS is the dominant health system in the state, holding between 45% and 55% of the total market share, with four hospitals, including the state’s only Level I Trauma Center.

Most QHS services are centered on the island of Oahu, although the system does offer community hospital services and select physician services on neighboring islands. In recent years, QHS has experienced exceptional ambulatory growth, leading to increased demand and extended delays in care for ambulatory and outpatient imaging services.

QHS engaged ECG to partner with its imaging team to drive comprehensive access improvement by conducting an in‑depth evaluation of the system’s various imaging resources and initiating activities related to opportunities identified.

Improving access to imaging services at QHS involved collaborating with QHS leadership to develop a broader and prioritized medical imaging master improvement plan. ECG visited the primary Queen’s Medical Center (“Manamana”) and community-oriented West Oahu campuses to observe MRI, CT, mammography, IR, cath lab, and echo services, as well as interviewed key leaders and providers to identify areas of opportunity. Additionally, ECG reviewed Epic scheduling templates for MRI, CT, and mammography and developed plans to increase patient throughput. 

After completing interviews and observations, ECG created a list of modality-specific and organization-wide imaging improvement initiatives and met with modality leaders to vet initiatives and discuss implementation feasibility and timelines. Once initiatives were prioritized and agreed upon, ECG collaborated with operations managers to implement changes and track progress. In parallel, ECG provided QHS with digital options to increase patient throughput and optimize workflows such as the implementation of 3DR Labs, Siemens Healthineers’ WeScan remote scanning, and a conditional ordering process.

By the completion of the engagement, QHS had increased equipment utilization and imaging volumes and reduced the time from order to appointment. Notably, the system opened more capacity for callback/additional view images in mammography, decreasing the wait time from screening to callback appointment for women. QHS also successfully implemented improvement initiatives in MRI, CT, and mammography such as expanded hours, template optimization, and the rapid hiring of travel technologists, which led to increased volumes without placing any further burden on already burned-out staff. 

ECG partnered with leaders at Manamana and West to standardize processes and templates across the system. In conjunction with this work, we identified scheduling and prior-authorization enhancement opportunities, as well as no-show mitigation tactics that are being administered by the Patient Support Center. We also implemented an MRI outbound text campaign where we added 65 slots per week and scheduled 45 patients within two days. Finally, we helped QHS create a long-term roadmap for the imaging team to continue working to increase access. 

QHS has now developed the foundation and structure to provide increased access to its patients. Implementing sustainable initiatives through workflow optimization and digital enhancements led to an accelerated impact on access. The implementation of cohesive, effective, and sustainable medical imaging services at QHS in the near term while ensuring such improvements are sustainable for years to come will position QHS to meet patient demand while expanding its market share.