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What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

The attached Vitals Charts demonstrate the weekly Demand, Activity, Backlog and individual patient’s Lead times, across the whole Radiology Network.  These clearly show the impact of the COVID shutdown on both Demand and  Activity.  The backlog (the cumulative difference between Demand and Activity) allows the teams to predict and plan the required activity to meet the required  RTT Lead times.  The Vitals Charts have provided data the DMO1 is currently unable to do. In addition, information on Lead times for both Request to Scan and Scan to Report has demonstrated significant variation in Lead times across Kent & Medway sites, demonstrating an inequitable service.  Having demonstrated what is possible, this project will train the Radiology and Data Manger from each of the four sites in the K&M ICS to learn this skill for themselves,  thus improving their capability to meet the clinically required lead times.

What does your project aim to achieve?


  • Build in house capability across four acute sites and within the Kent & Medway Imaging Network
  • Provide a standard format for data to demonstrate the relationship between Demand, Activity and Backlog, currently not available via DMO1.
  • Produce Lead times data to demonstrate variation in Lead times from Request – Scan and Scan to Report.
  • Use data to understand root cause analysis of variation and plan improvement to provide patient equity.
  • Develop real-time clinical dashboards across the ICS and Imaging network
  • Once skills have been developed this team of 10 will be able to train other Managers and Data Analysist to produce Vitals Charts for other areas of the Emergency and Elective pathways.

How will the project be delivered?

The project will use the established Healthcare Systems Engineering approach This is an online training programme, designed for those training to work at a rate they are capable of managing within their working schedule. The format of Demand and Capacity training is not available elsewhere.

To demonstrate their competency each trainee is required to undertake a series of Case Studies (Brain Teasers) containing real, anonymised data in all aspects of healthcare including A&E, Pathology, 5 day v 7 day working etc.

Training would be provided to 4 Radiology Managers and 4 Data Leads in each acute provider and one manager and one data lead in the K&M ICS.  Each of these 10 individuals will work with a clinical team in one chosen Radiology modality to build and demonstrate their learning, which will include statistically significant improvements to the backlog and lead times within one year.

How is your project going to share learning?

To pass the competency each trainee is required to produce a written case study which includes methodology and data to demonstrate application of methodology and outcomes which will be measured in term of Safety, Flow, Quality and Productivity. The case studies will be shared within each acute Trust, across the network and ICS, shared with Q participants and published on Imaging Network Website (underdevelopment) and on Healthcare Systems website Journal of Improvement Science JOIS.

We propose a series of Zoom Casts through the Royal College of Radiologist and Society and College of Radiographers. In addition a website for the newly formed Kent and Medway Imaging Network will carry information on the outcomes.

Recent discussions have taken place with Professor Sir Mike Richards who is very keen to see this embedded with the Kent & Medway network to support his recent review Diagnostics: Recovery and Renew.

How you can contribute

  • Each team will be provided with a HCSE Level 2 mentor and coach
  • All Level 2 HCSE are Q members
  • The will act act as mentors and coaches and have demonstrated their competence by working with a clinical team and published a real Case Study on the Journal Of Improvement Science website.
  • Each Level 2 HCSE continues to build their skills and have formed a learning network; Community of Healthcare Practitioners who meet regularly to share ideas develop learning in other aspects of healthcare

Plan timeline

21 Sep 2020 Identify trainees in each acute site and ICS


  1. Hi Lesley

    This proposal for using QI in a data-driven, system-based approach is a powerful combination for supporting Radiology in dealing with 'front and centre' healthcare issues, now and in the future.

    This looks like a really worthwhile project.

  2. Guest

    Susie White 1 year, 3 months ago

    Thank you Lesley for applying for this funding to develop our use of the vitals chart software at Maidstone and Tunbridge Wells NHS Trust Radiology department.. your analysis of our present demand, capacity and backlog data has already proved invaluable and I can see trends emerging that can inform our practice almost immediately. There is obviously tremendous worth in good data and even more in good data analysis and I am convinced that this software holds the key to a deeper understanding of the effect of our processes on workflow that may be impeding our progress to improve efficiencies and I am keen to be able to use this data more fully in the future.


    1. Guest

      Lesley Wright 1 year, 3 months ago

      Just a technical amendment from Susie's comment. It isn't a software solution, it is using Excel and RIS data and build capability and competency to produce Vitals Charts. Ultimately this can be done on a weekly / daily basis to have realtime Clinical dashbords

    2. Guest

      Karen Fechter 1 year, 3 months ago

      Thanks for responding Lesley and Susie.

  3. Hi

    I'd be really interested in hearing more from a colleague in the Kent and Medway Imaging network about plans for how the requested funding will be utilised?  I think there's probably a lot more to it than the payment of external consultancy and training fees but it's not coming through for me at the moment.  Would be great to hear more.

    1. Karen

      I will encourage someone from the Network to respond to you. If you have a look at the site you can login and look at all the case studies across all healthcare disciplines that have used Vitals Charts to use the data to make evidence based improvement.

  4. Dear Pete

    I have identified Kate Silvester and Simon Dodds. Simon set up the Healthcare Systems Engineering programme and the case studies which demonstrate the competency to train at ISP Level 1 or Level 2 which would be a requirement, are on the Journal of Improvement Science website

    Happy to have any support in the next part of the process


    Kind regards


  5. Hi Lesley,

    Myself and my colleague Emma Adams (Health Transformation Partnership) are supporting the Health Foundation this year by fostering conversations between Q members and encouraging collaboration. We were Exchange applicants last year, so we’re hoping that our experience will help us to help others, as their ideas take shape.

    I noted that you mentioned a small number of Q members who are  trained in Healthcare Systems Engineering. I wondered if you'd already identified those people. If not, one I know is James Ward:

    Also, due to the nature of previous work, I do know a number of people who specialise in flow (reduce backlog, delays and increase throughput) - should you need to recruit people as part of the project and want further connections, do let me know.

    I'll also keep my eye out as I read other ideas for areas of mutual interest and connection.

    Best of luck with your project.


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