Practice Policy and Quality Initiatives: Decreasing Variability in Turnaround Time for Radiographic Studies from the Emergency Department

Towbin, Alexander J.; Iyer, Srikant; Brown, James M.; Varadarajan, Kartik; Perry, Laurie A.; Larson, David B.

doi:10.1148/rg.332125738

Cited by 41 publications

(20 citation statements)

References 19 publications

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“…Even those driving initiatives to decrease turnaround time emphasize the dependence on "the professionalism of the radiologists to provide care in a manner they considered safe" (8). The message is clear: Accurate, high-quality reports must take precedence over speed, despite unrelenting financial pressures and high patient or provider expectations.…”

Section: Computing and Reporting Technologies: Opportunities And Riskmentioning

confidence: 99%

Radiologic Professionalism in Modern Health Care

Hryhorczuk¹,

Hanneman²,

Eisenberg³

et al. 2015

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Modern radiology is at the forefront of technological progress in medicine, a position that often places unique challenges on its professional character. This article uses "Medical Professionalism in the New Millennium: A Physician Charter," a document published in 2002 and endorsed by several major radiology organizations, as a lens for exploring professional challenges in modern radiology. The three main tenets of the Charter emphasize patient welfare, patient autonomy, and the reduction of disparities in health care distribution. This article reviews the ways in which modern technology and financial structures potentially create stressors on professionalism in radiology, while highlighting the opportunities they provide for radiologists seeking to fulfill the professional goals articulated in the Charter. Picture archiving and communication systems (PACS) and voice recognition systems have transformed the speed of radiology and enhanced the ability of radiologists to improve patient care but also have brought new tensions to the workplace. Although teleradiology may improve global access to radiologists, it may also promote the commoditization of radiology, which diminishes the professional stature of radiologists. Social media and patient portals provide radiologists with new forums for interacting with the public and patients, potentially promoting patient welfare. However, patient privacy and autonomy are important considerations. Finally, modern financial structures provide radiologists with both entrepreneurial opportunities as well as the temptation for unprofessional conduct. Each of these advances carries the potential for professional growth while testing the professional stature of radiology. By considering the risks and benefits of emerging technologies in the modern radiology world, radiologists can chart an ethical and professional future path.

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Section: Computing and Reporting Technologies: Opportunities And Riskmentioning

confidence: 99%

Radiologic Professionalism in Modern Health Care

Hryhorczuk¹,

Hanneman²,

Eisenberg³

et al. 2015

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“…The principal contribution of the radiologist to the ED and patient care consists of imaging reports issued promptly and accurately. These reports prevent time loss of patients in the ED and unnecessary crowding (23). One study comparing teleradiology with radiological opinions by telephone showed that in the event of teleradiology being used, the time between imaging being performed and a report issued was less than 34 min (24).…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Patients Receiving Teleradiology Consultations for Computed Tomography in the Emergency Department

Turgut¹,

Bucak²,

Almış³

et al. 2019

Istanbul Med J

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Amaç: Teleradyolojinin, acil servislerde hastalara zamanında ve doğru tanı konmasında önemli bir işlevi vardır. Bu çalışmamızda acil hekiminin teleradyolojiyi daha çok hangi durumlarda kullandığını inceleyerek, acil servislerde teleradyoloji kullanımını etkileyen faktörleri tespit etmek istedik. Yöntemler: Bir ay boyunca acil servislerde çekilen bilgisayarlı tomografi (BT) görüntülerini retrospektif olarak inceledik. Acil hekiminin teleradyolojiden hemen raporlama istediği (grup 1) ve raporlama istemeyip kendisinin değerledirdiği hastaları (grup 2); demografik özellikleri, şikayetleri, sonlanımları ve tekrar başvuru açısından karşılaştırdık. Bulgular: Çalışmada toplam 1999 hasta olup, bunların 831'i grup 1 1168'i ise grup 2'ye aittir. Grup 2'deki (42,87±25,12 yıl) hastalar grup 1'dekilerden (38,78±25,03 yıl) daha yaşlıdır (p<0,01). Adli olgularda raporlanma oranı (%85,8) adli olmayanlara göre anlamlı düzeyde daha yüksektir (p<0,05). Acil hekimleri en fazla raporlamayı karın ağrısı şikayetiyle hastaneye başvurup abdomen BT çekilen hastalara istemiştir (p<0,05). Acil hekimi hastaneye yatırılan ve ölen olgulara taburcu olanlara göre daha fazla raporlama talep etmiştir (p<0,05). Teleradyoloji konsültasyonu yapılmadan taburcu edilen olguların acile tekrar başvuru oranı, teleradyolojiye konsülte edilip taburcu edilenlerinkinden anlamlı düzeyde daha yüksektir (p=0,01). Sonuç: Bu araştırmada, adli olgularda, karın ağrılı hastalarda, hastaneye yatırılarak tedavi edilmesi gereken hastalarda ve mesai dışındaki saatlerde acile başvuran hastalarda teleradyolojinin daha fazla kullanıldığını tespit ettik. Anahtar Kelimeler: Acil, teleradyoloji, bilgisayarlı tomografi, karın ağrısı Introduction: Teleradiology plays an essential role in the accurate and prompt diagnosis of patients in the emergency department (ED). This study aimed to analyze some factors affecting the use of teleradiology in EDs. Methods: We retrospectively examined computerized tomography (CT) images taken in our ED over one month. We compared patients for whom emergency physicians (EP) requested an immediate report via teleradiology (group 1), and patients for whom they requested no report and assessed themselves (group 2), in terms of demographic characteristics, complaints, outcomes, and re-admission. Results: The study population consisted of 1999 patients, 831 in group 1, and 1168 in group 2. The patients in group 2 were older (42.87±25.12 years) than those in group 1 (38.78±25.03 years) (p<0.01). The proportion of reports issued in forensic cases (85.8%) was significantly higher than that in non-forensic cases (p<0.05). EPs most commonly requested reports for patients presenting to the hospital due to abdominal pain (p<0.05). EP requested significantly more reports for patients admitted to the hospital and for subjects who died (p<0.05). The re-admission rate among patients who were discharged without teleradiology consultation was higher than the re-admission rate of those who were discharged after the teleradiology consultation (p=0.01). Conclusion: Our...

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“…Reduced overall turnaround times may also lead to reduced time to diagnosis with the potential to improve satisfaction among referring providers (11,12). Although we did not formally assess patient satisfaction related to time to schedule an outpatient MR imaging examination during the study period or maintenance phase, there were no obvious negative effects on the department's regularly reported patient satisfaction scores.…”

Section: Lessons For Future Improvementmentioning

confidence: 97%

Reducing Barriers to Timely MR Imaging Scheduling

Wessman¹,

Moriarity²,

Ametlli³

et al. 2014

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Scheduling a magnetic resonance (MR) imaging study at the authors' large health system in 2011 required considerable preparation before an appointment time was given to a patient. Difficulties in promptly scheduling appointments resulted from the varying time required for examinations, depending on the requested protocol, availability of appropriate MR imaging equipment, examination timing, prior insurance authorization verification, and proper patient screening. These factors contributed to a backlog of patients to schedule that regularly exceeded 300. A multidisciplinary process-improvement team was assembled to improve the turnaround time for scheduling an outpatient MR imaging examination (the interval between the time when the order was received and the time when the patient was informed about the MR imaging appointment). Process improvements targeted by the team included protocol turnaround time, schedule standardization, schedule intervals, examination timing, service standards, and scheduling redesign. Using lean methods and multiple plan-do-check-act cycles, the time to schedule an outpatient MR imaging examination improved from 117 hours to 33 hours, a 72% reduction, during the 9-month study period in 2011-2012. The number of patients in the scheduling queue was reduced by 90%. Overall MR imaging examinations within the specific patient population studied increased from 773 patient studies during the first month of intervention to 1444 studies the following month and averaged over 1279 patient studies per month throughout the study.

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Practice Policy and Quality Initiatives: Decreasing Variability in Turnaround Time for Radiographic Studies from the Emergency Department

Cited by 41 publications

References 19 publications

Radiologic Professionalism in Modern Health Care

Radiologic Professionalism in Modern Health Care

A Retrospective Analysis of Patients Receiving Teleradiology Consultations for Computed Tomography in the Emergency Department

Reducing Barriers to Timely MR Imaging Scheduling

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