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Activities That Do Not Add Value (Muda).

Waiting is an activity that does


not add value, whether it be waiting for patients to arrive, register, and undress;
for an intravenous line to be inserted and sedation to work; for transport
personnel, the bedside cytologist, or isotopes to arrive; or for images to be sent
to a picture archiving and communication system (PACS) workstation and for the
workstation to boot up. Likewise, performing unnecessary or redundant imaging
examinations or inappropriately targeted or excessive image acquisitions could
be charac- terized as muda.
Unplanned Variations in a Process (Mura).In the clinical radiology setting,
failures of equip- ment and differences among patients with regard to body
habitus and comorbidities may con- tribute to waste by causing process
variations. Likewise, the lack of standardization in protocols for imaging and
interventional procedures or in choices of catheters and procedural equipment
may lead to inefficiencies in a process.
Overuse of Staff, Equipment, and Systems (Muri).Overscanning, too
much fluoroscopy, too many patients scheduled for the same time slot,
unnecessary studies, and repeated studies all represent waste due to
overstressing.