Service Redesign: Enhancing Orthopedic OPD Imaging Efficiency

This report investigates the efficiency of the orthopedic outpatient department (OPD) imaging service, focusing on staff and patient experiences. The increasing demand for hip and knee replacements, driven by unhealthy lifestyles and rising obesity rates, is expected to strain the OPD imaging system. A staff satisfaction survey revealed dissatisfaction with imaging service efficiency, primarily due to a lack of digitalized equipment. The report explores three options: 'Do nothing,' replace the current system with Digital Radiography (DR), and replace the entire room with a DR wireless detector system. Each option is evaluated based on its impact on patient experience, resource costs, and potential risks. The preferred option is replacing the current system with DR, as it offers a balance of cost-effectiveness, improved patient care, and reduced waiting times, while minimizing disruption and the need for extensive staff training. The report concludes that this approach is the most sustainable for enhancing OPD imaging services.

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ORTHOPEDIC
by [NAME]
Course
Professor’s Name
Institution
Location of Institution
Date

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Orthopedic
Introduction
In healthcare, service redesign is one of the most important skills because of its
effectiveness and efficiency. This is important because the quality of service that is provided to
the patients is really of high quality. The most important aim of service redesign is to solve the
problem that involves that service mostly by redesigning its services. It also involves the service
analysis. Service redesign helps in increasing the speed and enabling that patient care is effective
mostly by eliminating the possibility of occurrence of an error, and reducing the number of steps
in a patient’s pathway.
Knee and hip replacement is expected to change in the next couple years because people
choose to live a poor lifestyle. This may eventually lead to arthritis due to obesity. Due to this the
number of patients requiring x-rays will increase, posing a great problem to the OPD service. To
improve the service, the stakeholders are trying to find a solution to tackle the coming problem.
The main objective of the report was to learn about the efficiency of the employees on both the
patients and the staff.
Orthopedic services
OPD clinic always has one room where the x-ray is done, a different room in which the
patients are allowed to change, and an exclusive awaiting room in which the patients wait to
undergo an x-ray operation. The x-ray room always has a Computed Radiography system.
Imaging facilities are also provided in OPD clinics both for post-operative and pre-operative
assessments. Patients are also provided with a follow-up assessment and that’s when they are
able to make an appointment. A support worker and two radiographers are often placed in the
orthopedic room. The two were allocated there to help the patients requiring x-raying.

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Reason for change
A survey regarding the satisfaction of staff was carried out and the result showed that
the staff was dissatisfied with the efficiency in the OPD room. This involved the efficiency of the
imaging services. There was lack of equipment’s used in the imaging services. The main issue
raised by the staff is lack of digitalized equipment in the OPD room. Lack of the digital
equipment caused a lot of problems in the OPD room. his made the staff be under pressure,
therefore, requiring the changes in the services to be employed. The amount of time needed by
the staff to do the x-ray operations was limited.
To identify problems in the patient pathway, OPD imaging was first reviewed and it showed
that whenever the patient's x-ray is taken to the OPD room, their pathway seemed shorter and
whenever the patient was told to go to the x-ray department, their pathway seemed a little longer.
This implied that the patients were very dissatisfied as they could wait longer before undergoing
an x-ray.
Option appraisals
Option 1 Option 2 Option 3
Description of Option ‘Do nothing’ Replace with Digital
radiography (DR)
wireless detector
system (DR detector
retro fit)
Replace the whole room
and change into a DR
room
Provide data to support
option and ‘best
practice’ evidence if
applicable.
 No money will
be spent on
improving the
service
 Most cost
effective to
upgrade from
CR to DR
 Speedy imaging
acquisition
 Decrease waiting
time for patients

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 Will not
require
additional staff
training
 No interruption
in the service
will be caused
 Increased
speed,
therefore
reducing
patient
waiting times
and so
improving
patient
satisfaction
 Quick and
easy one-day
installation
into existing
equipment to
increase
workflow and
productivity
(wolverson,
2017)
 Images can be
processed a lot
quicker
 Will not require
patients to be
referred to the
general x-ray
department for
their x-ray,
thereby reducing
steps in patient
pathway,
improving patient
flow and
improving patient
satisfaction.
Impact of service
change on patient
experience
 No change in
service impact
will be made
on patient
experience
 Better
healthcare
service
 Patient
waiting time
is reduced
 Improved
patient
satisfaction
 Same as option 2
Resources including
costs
Changes in
resources/costs/staffing
Type of costs affected
e.g. staffing, non-pay
(e.g. consumables),
buildings etc. Are they
one off resource
implications or
recurring?
 Same cost  Minimal
equipment
cost
(appendix 6).
 Lower service
and
installation
cost
(appendix 6).
 Most expensive
option as high
cost is involved
in the re-design
of a new x-ray
room (appendix
6)
 Higher
equipment,
service and
installation cost.
How will the service
change be delivered and
is it sustainable?
 No changes
will be made
and it is not
 Improved
patient care
 Changes will
 Same as option 2.

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sustainable as
according to
NHS
modernization
Agency, (2003)
patient waiting
time in
radiology is
being
exceeded.
be made to
the imaging
service; the
change will
be sustainable
as there will
be a decrease
in patient
waiting time
by
eliminating
unnecessary
steps.
 Will involve
training
radiographers
on the new
equipment.
Risks - identify
potential risks of the
option
Identify how you might
minimise any of the
risks
 Longer patient
pathways as
patient will
have to be
referred to
general x-ray
department due
to slow
imaging
services
 Short
Disruption in
the service
when the
equipment is
being
replaced
 Minimal cost
is involved
 Will require
staff to be
trained on the
new
equipment so
will take up
time
 Same as option 2
but in greater
threat
 Remodelling a
new DR room
would be most
expensive
 A wide range of
quality assurance
tests.
 Option 2 would
be able to
minimise most of
these risks.
Evaluation:
How will you evaluate
the changes you make?
Use of specific outcome
measures
No action is
required
 Carry out a
staff
satisfaction
survey and
analyse the
results
 Assess the
cost
effectiveness
to ensure
Same as option 2

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sustainability.
PREFERRED OPTION
Rank your option
1=worst and
3= best against the
following indicators/
a) Improved patient care
b) Improved access to
service
c) Cost effective
d) Improved staff
support / care
a) 1
b) 1
c) 3
d) 1
TOTAL SCORE =
6/12
a) 2
b) 3
c) 3
d) 3
TOTAL SCORE =
11/12
a) 2
b) 3
c) 1
d) 3
TOTAL SCORE = 9/12
Justification
Option 2 has a minimal cost, therefore, being the best way of improving the
effectiveness of the imaging services of the OPD. The best patient care is provided by this option
because it has an approach that is more focused. Option 3 would impact the budget of trust
financially even if both of option 2 and option 3 scores were similar. Fast patient positioning is
mostly provided by option 3 than option 2. This is because the movement of the tube is a little
automated. Option 3 is only advantageous for people with a trust of higher budgets. Therefore,
the third option has a lot of requirements from the society. It will then cause man disruptions in
the OPD imaging services because it will need the room to be newly constructed and be
equipped with digital equipment. The staff will also have to undergo training to ensure that they
are well conversant with all equipment and their operation.

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