The Challenge: Streamlining Cytology Support for Bronchoscopy

At Johns Hopkins Hospital, the bronchoscopy suite plays a crucial role in diagnosing and treating lung conditions. However, inefficiencies in cytology support, especially in Rapid On-Site Evaluation (ROSE) were leading to delays, staff burnout, and potential repeat procedure.

With only two cytotechnologists handling all procedures, the department faced:

• Scheduling inefficiencies within the EPIC system, leading to missed or delayed procedures.
• Underutilization of downtime between procedures, increasing workload backlogs.
• Bottlenecks in screening workflows, slowing down sample processing and patient diagnoses.

Our team partnered with Dr. Christine Argento to analyze workflow inefficiencies, conduct stakeholder interviews, and develop a strategic action plan to optimize operations.

Research & Process Optimization Strategy

1. Root Cause Analysis & Stakeholder Insights: We conducted 30+ stakeholder interviews, including cytotechnologists, pulmonologists, and nurses, to identify process inefficiencies. Key insights included:
   • Unclear scheduling & communication gaps resulted in unnecessary waiting times.
   • Cytotechnologists spent up to 7 hours per week idle due to inefficient scheduling.
   • Missed ROSE support in 20% of cases led to potential repeat procedures and delays.
2. Strategic Solutions for Improved Efficiency: Based on our findings, we proposed three key recommendations:
   • Smarter EPIC Scheduling System: Customizing EPIC to flag cytotechnologist requirements and improve scheduling coordination.
   • Hiring Additional Cytotechnologists: Expanding the team to increase screening capacity by 26% and reduce burnout.
   • Implementing Telecytology: Deploying remote screening solutions like Accuscope RC500, boosting efficiency by 11% and reducing unnecessary physical presence in procedures.

3. Quantifiable Impact & Outcomes: By implementing these changes, the hospital could:
   • Improve procedural efficiency by 67%, reducing unnecessary waiting time.
   • Save 7+ hours of cytotechnologist downtime per week, increasing productivity.
   • Enhance patient care by accelerating diagnostic turnaround times.

Lessons & Key Takeaways

Technology-driven scheduling reduces inefficiencies and optimizes staff workload.

Balancing automation (telecytology) with human expertise enhances operational efficiency.

Process improvements directly impact patient care, reducing delays and repeat procedures.

Final Thoughts: Bridging Healthcare & Operations

This project reinforced my passion for applying data-driven solutions to real-world operational challenges. By bridging technology, workflow optimization, and strategic planning, we were able to create a sustainable impact on hospital operations and patient care.