Flow in IR dept

[frann]

Just curious. How does the flow go in others IR dept? Are Rn's and techs assigned rooms? Do you have a specific person to answer phones?

Our flow is terrible. I'm at a 300 bed hosp. with outpt and in pt procedures. We usually have anywhere from 4-6 rn's ,4 techs, 1lpn in recovery, 1 IR doc with 1 as backup, 2 assistants-1 does restocking, etc other does nothing. Have no one to answer phones and schedule procedures. We have 3 IR rooms.

We don't have good time management. We're not working as team. Any suggestions:confused:

[DB 1959]

Hi Fran,

We have 2 IR rooms (one good room one room we mainly do lines in.) 3 techs and 2 RN's, the techs do all the ordering, each has his area he is responsible for. The supervisor orders all the interventional stuff. One tech orders all the pharmacy supplies, the other one orders everything else. They stock their own supplies. We all answer the phone, and schedule. Organization? well 2 techs in the "good" room and one in the other an RN is each room. We have one DR and we try and keep him busy going room to room. Hope this helped. I have never worked in anyother Rad. Dept.

Jan

[frann]

I just give up. We are so disorganized. Main trouble is half people here don't work.

[dianah, ASN]

We had three rooms: one cardiac, the other two IR. Three-four techs, 2-4 nurses, depending on who was there/had days off (4-10s schedule, etc). One tech assigned to each room, was responsible for the flow in his/her room. One tech fielded as many calls as possible. Nurse assigned to each room helped w/set-up, etc. Nurses responsible for inventory (usually got techs to help check things while the nurse made out the "order"). BTW, we had two IRs but usually only one was assigned to procedures for the day (if we wanted to move faster we'd beg him to have one of the other Rads help). One Cardiologist was assigned to the cath room (as well as having other duties, of course!).

Hope this helps. I'm now at a smaller facility, one cath lab only. Not as hectic! :)

I think it's a tough area (IR, that is) because it's SO, SO dynamic -- it's the nature of the beast, I'm afraid. It may often SEEM disorganized (to the passers-by) but that's not necessarily the reality.

[kckcgussyy]

I feel lucky !

we have 4 interventional suites

2 tachs,1 RN,1 Attending,1 Resident per room.

I rad supervisor,1 rad flow supervisor,1 RN manager, 1 RN educator,

We run 9-10 RN per day to staff all of Radiology.

1 RN for CT cases /and CTA

1 RN to float/ MRI cases / Litho cases/and any general anesthesia cases done in the RAD dept.

2-3 RN in holding (which is pre and post care) is a 4 bed area(its definetly TOO SMALL for our volumn and flow.

we staff from 0600-1930 M-F. weekday call 2 x per mo,and weekend call 2x in a 4 mo period.Nursing in this dept is all SELF-SCHEDULING.

kc

[sunnymqt]

I wish I knew how to schedule cases in two rooms inpatient and outpatient. It seems like lack of communication and confusion every day. We are trying to have outpatient days instead of trying to mix both.

[dianah, ASN]

sunny, how do you do it now? Do you use a book for each room, or is it via computer, or do you have a dry-erase board in each room, or in a central area? It's always hard to fit in the last-minute in-pt procedures; I think juggling is universal, in Radiology.

[sunnymqt]

We have a dry erase board for the two rooms. Do you schedule like permcath-one hour, angio- 2hours, shuntogram- 1hour, ect...

Seems the schedule always is behind and we have unhappy customers waiting. We are just starting to have outpatients on two days a weeke and not have many electives on Monday. We are always adding on after the weekend. We also have another procedure room without fluro that we use for para, thora and piccs.

Who does your scheduling? Central scheduling or department scheduling?

[dianah, ASN]

(note the date on the original post, but this subject, as they say, is timeless, lol!)

There's a "usual time" that each case will take, and then there's the amount of time it REALLY takes, when unexpected surprises surface. Sometimes the para is slick and we can move on to something else quicker than we thought we'd be able to . . .

I'm not in Radiology anymore, just Cath Lab, but whenever I schedule a pt to come in for a pre-cath talk with the MD, I always warn them we could be delayed d/t an emergency, or a case that takes longer than we expected (e.g., difficult access) -- so I tell them to bring a book and make sure they understand that when the doc is free, he'll be able to see them. We try to stay in contact with the Short Stay Unit, too, letting the nurses know that we're delayed starting d/t ___________, and to please inform the pt (we haven't forgotten him!!).

Mondays are busy d/t sick pts admitted over the weekend who need procedures; Fridays are busy, well, because they're FRIDAYS! Pts shouldn't have to take up a hospital bed all weekend because they're waiting for a procedure -- so do it on Friday, of course!

Sometimes we had to arrange the schedule because the only MD who did such-and-such procedure, wasn't scheduled to do procedures that day, or was off, or something.

A central clerk in Radiology did the scheduling (according to guidelines, including which MDs were assigned and which rooms we could do procedures in), although the techs arranged their individual room schedule.

Who does your scheduling now? It should be someone who knows something of the procedures, so that person knows how to schedule what procedure in what room, given the staffing complement for that day. Each team in each room took care of the schedule, but was not an island, in that the teams communicated back and forth, sometimes switching pts (on paper) from one room to the other, as the room opened up. Hopefully we could keep the IR running from room to room, efficiently.