Integrating a Waste Walk into Technology Adoption: A Primer

By Susan Williams, Director of Radiology, UW Medicine

Medical imaging administrators and physicians face growing pressure to adopt the latest advanced imaging and related technologies to meet clinical needs. These decisions must balance exceptional patient care, operational efficiency, and responsible capital spending. Yet new technology is often implemented without a full understanding of the problem that needs to be solved. When there is no clear and agreed-upon goal for a technology purchase, the result is often underutilization of the features of the product, staff frustration, and missed KPI targets.

Whether the goal is to acquire an AI solution, a new scanner, or a PACS, a waste walk offers a practical, low‑cost, and highly effective way to clarify the true needs of the project. By grounding decisions in firsthand observation, leaders can define shared goals, align stakeholders, and ensure that technology investments directly address the challenges at hand.

A waste‑reduction strategy during technology adoption enhances ROI and improves staff satisfaction.

What is a Waste Walk?

A waste walk is an activity rooted in Lean methodology. It is a structured, observational process in which stakeholders and end users walk through either a physical space, a technology workflow process or both. The scope of this focused observation is the value stream which is the entire set of actions required to bring a service or product from beginning to end. In imaging, this may start with the referral or scheduling and end with the final report or patient billing. If it’s a new scanner purchase, perhaps the starting point is prepping or positioning the patient to the end point of image QA. Whatever the project, the goal of the waste walk activity is to identify all non-value-added activities. This can then help to prioritize the list of requirements a new technology or upgrade must fulfill.

Effective planning and clear communication are essential for a productive waste walk. Begin by defining the scope of the observations, simply put, what will be included and what will not. Providing standardized forms for the observers helps ensure consistent data collection and is far more effective than relying on free‑text notes. Many standard templates are readily available online and through Lean resources.

Select the team thoughtfully. An overly large group can overwhelm staff, while too few participants may miss key insights. Take caution to avoid selecting only physicians or administrators. A diverse group, including both subject matter experts (SMEs) and individuals less familiar with the workflow, will yield the most comprehensive perspective.

The timing of the waste walk also matters. Challenges faced during nights or weekends often differ from those on day shifts. Conducting observations across different times, staffing levels, patient volumes, and locations ensures a complete understanding of workflow variation.

Finally, the most important step in planning is clearly communicating to the team why their work is being observed and how the information will be used. Without this context, staff may feel scrutiny or worry that their performance is being evaluated. Reassure them that the purpose of the waste walk is to understand workflow challenges, acknowledge their concerns, and identify opportunities to improve the systems that support their work.

DOWNTIME: 8 Categories of Waste

Observations of waste can be placed into eight categories and easily recalled with the acronym DOWNTIME:

Defects/Rework: Quality issues resulting in rescanning or longer interpretation time, dictation errors, charting errors, mislabeled images or specimens

Overproduction: Doing more than what is required or doing it sooner than needed, inefficient protocols, redundant documentation, unnecessary diagnostic procedures, printing forms that aren’t needed or could be viewed electronically

Waiting: Equipment idle time, patients waiting for transport, scans, or results. Handoff delays, slow acquisition or image transfer time

Not Utilizing Talent: Underutilizing a person’s skills or talent, such as a radiologist performing clerical tasks, a technologist or nurse registering or rooming patients

Transport: Unnecessary or excessive movement of people or supplies, reschedules, too many clicks, inefficient layout of rooms, poorly designed dashboards or reading lists

Inventory: Expired supplies, too much stock on hand or running out of needed items, not enough storage or memory

Motion: Lack of standardization, walking to distant phones or printers, misplaced materials or information, hard-to-find data or reports

Excess/Overprocessing: Doing work that is not value-added to the patient or ordering provider, forms that are redundant or the information isn’t used, entering the same data into multiple systems

After the Walk

Once the waste‑walk sessions are complete and the data has been analyzed, meet with the decision makers together to review the findings. Highlight the types of waste identified and discuss how closely they align with your original assumptions. Did anything unexpected surface during the walk? Were any immediate concerns uncovered that require prompt action?

Next, assess the potential or actual impact of each type of waste on patients, staff, and the hospital. Revisit the original project request with this new information in mind. Do the observations gathered during the waste walk change the features you were considering? Collaborate with your stakeholders to refine the list of requirements that the new technology must meet and share the criteria with the vendors you are evaluating.

The insights gathered during the walk can also inform the development of your KPIs (key performance indicators). Reducing or eliminating waste while maintaining high‑quality imaging not only strengthens ROI but also boosts staff satisfaction. Ultimately, a well‑executed waste walk provides a low-cost, clear, grounded understanding of the challenges your technology purchases must address.