Table 1

Impact improvements on CTQ characteristics

CTQ characteristicsBaselineNew Heart Team design
1 Number of patients referred3500 patients per year in both centres.
An average of 14 patients were discussed per day (location A n=9, location B n=5), with a range of 5–25 patients per day.		Provides the opportunity to grow by better satisfaction.
Maximum of 15 patients per day with low SD.
2 Total time spent per HT patient on average in minutes64 min (without imaging cardiologist)
75 min (with imaging cardiologist)		Although imaging cardiologist will take seat in every HT, reduced rediscussions and more efficient discussions reduce the expected total time spent per patient to 53 min (reduction of 30%).
3 Lead time: time from referral to HT decisionMajority 1–2 days, rediscussions add lead time.Prevents rediscussions, thus reduction is expected.
4 Rediscussions23%
The main reasons: information/diagnostics incomplete, not enough time to finish discussion list and expertise not present.		All prerequisites in place to make decisions first time right, expected to result in less rediscussions and less last-minute cancellations.
5 HT efficiency: value-added timeValue-added time: 46% is spent on patient discussions.
Non-value-added time: external disturbances (4%), late start (16%), rediscussions (18%), administration (18%) and searching for patient information (10%).		A better prepared HT, as well as a more structured, orchestrated and timely HT, is expected to reduce non-value-added activities (waste) and increases the proportion of value-added time.
6 Referrer satisfactionOverall: 6.6 (SD 1.0)
Admission process: 7.4 (SD 0.7)
Communication planning: 7.3 (SD 1.4)
Communication physicians: 6.5 (SD 1.6)
Information: 6.5 (SD 1.2)
Involvement: 6.4 (SD 1.1)
IT infrastructure: 5.7 (SD 1.9)		At least a score of 7 out of 10 is expected because of:

  • Proactive expectation management.

  • Better communication.

  • Informing/communicating on reasons for decision.

  • Involvement.

7 Staff satisfactionOverall: 5.8 (SD 1.2)
Efficiency: 5.5 (SD 1.7)
Support: 5.3 (SD 1.6)
Quality: 7.0 (SD 1.1)
Communication: 5.5 (SD 1.8)		At least a score of 7 out of 10 is expected because of:

  • Improved work circumstances, facilities and culture.

  • Clearer tasks, expectations and responsibilities.

  • Reduced administration burden.

  • CTQ, Critical to Quality; HT, Heart Team; IT, information technology; SD, Standard Deviation.