Optimizing MRI Logistics: Prospective Analysis of Performance, Efficiency, and Patient Throughput

Beker, Kevin; Garces-Descovich, Alejandro; Mangosing, Jason L.; Cabral-Goncalves, Ines; Hallett, Donna; Mortelé, Koenraad J.

doi:10.2214/ajr.16.17698

Cited by 35 publications

(25 citation statements)

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“…In order to optimize the utilization of MRI in the most cost-efficient manner, most radiology practices attempt to optimize exam protocols and MRI scheduling to minimize wasted time and resources. 3 Typically, these efforts focus on limiting the number of acquired sequences, thereby limiting overall exam time. 4 However, process optimization emphasizes minimizing both waste and variation as key steps in process improvement.…”

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confidence: 99%

Factors predicting the time‐length variability of identically protocoled MRI exams

Avey

Belden

Zea

et al. 2019

Magnetic Resonance Imaging

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Background Clinical variability in MRI exam durations can impede efficient MRI utilization. There is a paucity of data regarding the degree of variability of identically protocoled MRI studies and when nontechnological factors contribute to time‐length variations in MRI exams. Purpose To measure the magnitude of variation in MRI exam duration for identically protocoled MRI exams and to identify potential contributors to variations in MRI exam times. Study Type Retrospective. Subjects 2705 identically protocoled MRI examinations of the cervical spine without contrast, comprehensive stroke exams, and comprehensive brain examinations performed on adult patients from June 30, 2016 through June 30, 2017. Assessment MRI exam duration was obtained directly from the image data. Potential predictors for exam length variability were evaluated including patient age, patient gender, performing technologist, patient status (inpatient/outpatient/emergency department), MRI field strength, use of sedation, day of week, and the time of day. Statistical Tests Linear regression analysis was performed for each individual variable after correcting for the MRI exam type. A multivariate mixed model was generated to assess for independent associations between the predictors and exam duration. Results There was substantial variability in the duration of the selected clinical MRI exams, with standard deviations (SDs) ranging between 19% and 29% of the mean exam length for each individual type of exam. The performing technologist was the most significant identified factor contributing to this variation in exam length; SD = 2.645 (P < 0.001). Compared with outpatient exams, inpatient exams required 4.18 minutes longer to complete (P < 0.001), and emergency department studies 1.86 minutes longer (P = 0.005). Male gender was associated with an additional 1.36 minutes of exam time (P < 0.001). Data Conclusion Nontechnical factors are associated with substantial variation in MRI exam times. These variations can be predicted based on relatively simple clinical and demographic factors, with implications for MRI exam scheduling, protocol design, staff training, and workflow design. Level of Evidence: 4 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2019.

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Factors predicting the time‐length variability of identically protocoled MRI exams

Avey

Belden

Zea

et al. 2019

Magnetic Resonance Imaging

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“…However, a tendency exists for such newly developed sequences and other techniques to continually be added to earlier MRI protocols, rather than to replace existing sequences, thereby leading to progressively longer imaging times and associated workflow challenges. can cause substantial improvement in patient centricity (patient centeredness) and workflow efficiency in MRI departments (7)(8)(9). Common causes of delay, which increases non-value-added time, include intravenous or port access issues (the most frequent source of delay), patient needs (eg, issues with paperwork), the late arrival of an interpreter, and concerns about implants or other safety issues.…”

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confidence: 99%

Abbreviated MRI Protocols for the Abdomen

et al. 2019

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Technical advances in MRI have improved image quality and have led to expanding clinical indications for its use. However, long examination and interpretation times, as well as higher costs, still represent barriers to use of MRI. Abbreviated MRI protocols have emerged as an alternative to standard MRI protocols. These abbreviated MRI protocols seek to reduce longer MRI protocols by eliminating unnecessary or redundant sequences that negatively affect cost, MRI table time, patient comfort, image quality, and image interpretation time. However, the diagnostic information is generally not compromised. Abbreviated MRI protocols have already been used successfully for hepatocellular carcinoma screening, for prostate cancer detection, and for screening for nonalcoholic fatty liver disease as well as monitoring patients with this disease. It has been reported that image acquisition time and costs can be considerably reduced with abbreviated MRI protocols, compared with standard MRI protocols, while maintaining a similar sensitivity and accuracy. Nevertheless, multiple applications still need to be explored in the abdomen and pelvis (eg, surveillance of metastases to the liver; follow-up of cystic pancreatic lesions, adrenal incidentalomas, and small renal masses; evaluation of ovarian cysts in postmenopausal women; staging of cervical and uterine corpus neoplasms; evaluation of müllerian duct anomalies). This article describes some successful applications of abbreviated MRI protocols, demonstrates how they can help in improving the MRI workflow, and explores potential future directions. ©

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“…Over the past several years, increased emphasis has been placed on measuring and improving the value of imaging [1–3]. Given its popularity and associated costs, MRI has been a frequent subject of these evaluations, with most assessments focused on improvements in hardware and software.…”

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confidence: 99%

“…One topic that has the potential to greatly improve the value of MRI but has not been studied as extensively as other topics is the optimization of MRI workflow [3, 10, 11]. When workflow is studied, the Lean Six Sigma approach has frequently been used to understand where process improvements can be achieved.…”

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“…Value-added time is defined as an activity that benefits the patient directly, business value–added time (i.e., business VAT) encompasses activities that are required but do not directly influence patient care (such as room cleaning), and non–value-added time is time spent on activities that are not necessary and add no benefit to the patient. A recent study showed that value-added time comprised only 38% of the entire patient stay for MRI examinations, with business value–added time accounting for 32% and non–value-added time accounting for 29% [3].…”

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Optimization of MRI Turnaround Times Through the Use of Dockable Tables and Innovative Architectural Design Strategies

Recht

Block

Chandarana

et al. 2019

American Journal of Roentgenology

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OBJECTIVE.-The purpose of this study is to increase the value of MRI by reengineering the MRI workflow at a new imaging center to shorten the interval (i.e., turnaround time) between each patient examination by at least 5 minutes. MATERIALS AND METHODS.-The elements of the MRI workflow that were optimized included the use of dockable tables, the location of patient preparation rooms, the number of doors per scanning room, and the storage location and duplication of coils. Turnaround times at the new center and at two existing centers were measured both for all patients and for situations when the next patient was ready to be brought into the scanner room after the previous patient's examination was completed. RESULTS.-Workflow optimizations included the use of dockable tables, dedicated patient preparation rooms, two doors in each MRI room, positioning the scanner to provide the most direct path to the scanner, and coil storage in the preparation rooms, with duplication of the most frequently used coils. At the new imaging center, the median and mean (± SD) turnaround times for situations in which patients were ready for scanning were 115 seconds (95% CI, 113-117 seconds) and 132 ± 72 seconds (95% CI, 129-135 seconds), respectively, and the median and mean turnaround times for all situations were 141 seconds (95% CI, 137-146 seconds) and 272 ± 270 seconds (95% CI, 263-282 seconds), respectively. For existing imaging centers, the median and mean turnaround times for situations in which patients were ready for scanning were 430 seconds (95% CI, 424-434 seconds) and 460 ± 156 seconds (95% CI, 455-465 seconds), respectively, and the median and mean turnaround times for all situations were 481 seconds (95% CI, 474-486 seconds) and 537 ± 219 seconds (95% CI, 532-543 seconds), respectively. CONCLUSION.-The optimized MRI workflow resulted in a mean time savings of 5 minutes 28 seconds per patient. Keywords dockable table; MRI; turnaround time; value Over the past several years, increased emphasis has been placed on measuring and improving the value of imaging [1-3]. Given its popularity and associated costs, MRI has

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Optimizing MRI Logistics: Prospective Analysis of Performance, Efficiency, and Patient Throughput

Abstract: Non-value-added time represents approximately one-third of the total MRI process cycle and patient length of stay. Identifying specific delays may expedite the application of targeted improvement strategies, potentially increasing revenue, efficiency, and overall patient satisfaction.

Cited by 35 publications

References 13 publications

Factors predicting the time‐length variability of identically protocoled MRI exams

Factors predicting the time‐length variability of identically protocoled MRI exams

Abbreviated MRI Protocols for the Abdomen

Optimization of MRI Turnaround Times Through the Use of Dockable Tables and Innovative Architectural Design Strategies

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