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Internship Project

Elizabeth Kiger

KINS 4306: Internship in Public Health

Georgia College & State University

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Need for Project

This summer I have had the opportunity to work alongside the imaging leadership team

as well as my supervisor to improve the diagnostic radiology and MRI teams at Emory Johns

Creek Hospital. The Director of Imaging came to my supervisor and asked for help to get MRI

and diagnostic radiology to reach their set goals of 95% on likelihood to recommend this hospital

on the patient satisfaction surveys. The rolling three month average mean score for MRI has been

92.8% and 94.5% for diagnostic radiology. This has resulted in a decrease in morale and in

ability when trying to meet the service expectations of the Johns Creek and surrounding

community.

Project Description

As a team throughout this summer we worked to determine what factors were causing

these departments to not reach their target mean scores of 95%. The scores are determined by the

number of people that answer ‘very good’ on the patient satisfaction survey when asked how

likely they are to recommend EJCH. I began my project by first going through a list of patient

satisfaction surveys and identifying patients that answered the question we use to collect the

mean scores as ‘good’ instead of ‘very good’. I then proceeded to get their contact information

and called them for a phone interview. There were 15 total people I called and I was able to

interview 9 of them regarding their outpatient experience at EJCH’s imaging department.

The next step in the process was to conduct employee focus groups. Both modalities were

invited to participate while their management and leadership team were not invited. This was so

that the staff would feel comfortable sharing some issues they see within these departments.

Among all employee focus groups they expressed the need for more staffing. Many of the staff

was also unhappy with the cleanliness of the MRI rooms because there is no routine clean for the
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rooms or equipment. They also shared a lot about the patient's discomfort with the snap gowns

they have to use and how difficult they are to put on. 

Next, I did some Gemba observations in both x-ray and MRI. During my x-ray

observations I was given a list of questions that I had to look for when observing the staff’s

interactions with the patients. After their imaging I would then separately ask the patient about

their x-ray experience and how they thought it went. I did not find my x-rays observations to be

very beneficial because the most of the patients I spoke with had great experiences and no

suggestions for improvements.

During my MRI observations I was more focused on observing the flow and processes

of it. I also asked the technologist who was doing the MRIs a few questions about her role in the

process and some areas she sees issues regarding the flow. I noticed early on the need for two

technologists working at one MRI scanner because with only one it really slowed down the flow.

The single technologist was required to go to the waiting room and pick up the patient then do

their procedure then return them to the waiting room. They would then come back and clean and

prep the MRI room for the next patient and then go and pick them up. When there were two

technologists in the room it allowed one to bring the patient back to the waiting room and pick

up the next patient while the other technologist stayed and prepped the room. Although this may

seem like only a few minutes time difference it had a large impact because MRI appointments

are usually heavily delayed at this facility. The delays are caused by patients coming in late for

their appointments, having to stop their scan because they are claustrophobic, inpatient and

emergency department patients coming in, and many other delaying factors. 

Throughout this whole process we had many meetings with the radiology leadership team

to discuss our findings and suggest solutions. There were a few solutions we believed would
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make a large impact and would require minimal effort to implement. One solution included

putting a circulator in the waiting rooms. This person would get information from the front desk

as well as the technologists in procedures and then notify patients in the waiting rooms about the

delays and estimations on when they should expect their procedure. Another goal we hope to

implement this July is replacing the snap gowns with more comfortable clothing such as

disposable shorts or scrubs. Some larger implementations that will be put into action in the

following quarters include hiring more technologists during peak periods and hiring a trained

radiology technologist scheduler. This will prevent scheduling errors because they will be trained

and aware of how to prevent reoccurring scheduling issues. 

Materials Created

I was responsible for creating an A3 presentation to share my work with the hospital’s

leadership teams as well as the CEO and Chief Nursing Officer. The A3 explains the steps we

took as a team to improve these departments, our findings, common trends and themes, and

potential implementations. During the presentation the CEO and CNO had many great questions

that my supervisor, the imaging director, and I were all able to collaborate on and answer.

Evaluation of Project

I believe the work I did with this project has made a large impact on the radiology

department. I really enjoyed this project because I was able to learn many great skills throughout.

I would not have changed anything that occurred throughout this project because I believe we

did everything in the most successful and efficient manner. Although I will not be here when

some of the greater impact solutions will be implemented I know they will be extremely

beneficial to this department. I am confident that diagnostic radiology and MRI will be able to

reach their target mean scores of 95% in the upcoming quarter.