Abstract

Johnson T. Seeing the Voice of the CT System: Part 1. Journal of Improvement Science 2025: 110; 1-15.

This project was inspired by a presentation given by two Health Care Systems Engineers (HCSE) at a regional imaging network event in 2023. In attendance was the Chief Operating Officer (COO) for our District General Hospital who requested a similar piece of work to be undertaken locally. The original project, undertaken in Maidstone and Tunbridge Wells NHS Foundation Trust [1], had shown the success of understanding a system through a visualisation tool called a Diagnostic Vitals Chart® (DVC).

An informal conversation with the COO showed a willingness to support as best they could with the project, and a recognition of the art of the possible, in terms of the visualisation of the system. It was clear this was something they had not seen previously, not just within imaging but in all service areas.

Following the discipline of the 6M Design® process, a full set of maps were created with the key stakeholders before attempting to take a look at some of the measures which is where the learning really began for the author.

This paper reflects the trials and tribulations of a relative novice HCSE uncovering the many pitfalls and banana skins that lie in wait for the unsuspecting but excitable practitioner.

The key findings are:
1. Lack of awareness of how to correctly extract data to create Diagnostic Vitals Chart® from those who have access to the information.
2. Recognition of the competing priorities of each stakeholder and the importance of an agreed shared focus for any improvement work.
3. The importance of regular communication with key stakeholders and a rhythm of scheduled meetings to ensure progress.
4. The need for tenacity, determination, and empathy to support teams through the "nerve curve" [2] to support their own personal journey through the unknown.
5. The CT Diagnostic Vitals Chart® has been an extremely useful visualisation tool in highlighting booking practices, changes overtime and potential focus areas.

4N Chart; 6M Design (6M); Activity; Backlog; Computer Tomography (CT); Demand; Diagnostic Vitals Chart (DVC); Health Care Systems Engineering (HCSE); Healthcare; Lead Time; Radiology; Radiology Information System (RIS); Time Trap; Utilisation; Work In Progress (WIP)