Ashley Corbett Bragg MD, Presenter: Nothing to Disclose

Aubrey Jade Slaughter MD, Abstract Co-Author: Nothing to Disclose

Teresita L. Angtuaco MD, Abstract Co-Author: Nothing to Disclose

To determine the impact of changing routine ultrasound scanning protocols from static to cine clips on workflow and overall work environment.

Abdominal, pelvic and neonatal head ultrasound studies were selected for this project due to their high volume.  Old  scanning protocols consisting exclusively of static images were reviewed and a new protocol  consisiting of  a majority of cine clips and very limited number of static images was instituted.  One month log of studies in these three areas were reviewed before the change in protocols and one year after full implementation of the new protocol.  Outcome measures were time savings, impact on efficiency and change in sonographer and sonologist behaviors as determined by a survey.

There was a significant effect on time savings in all studies: 47 % for neonatal heads, 19 % for complete abdominal studies and 51% for pelvic examinations. Evaluation of the impact on sonographers showed significant decrease in repetitive stress disorders, less resistance to portable examinations and decrease in repeat studies.  Both resident and staff sonologists relate easier distinction between artifact and true findings, less rescan times needed to confirm sonographer findings and easier communication with referring clinicians resulting in more confidence in diagnosis and improvement in daily workflow. Disadvantages include increased archive storage requirements from an average of 16-19 MB to 177-327 MB, decrease in actual resident hands-on scanning experience and the need for PACS system upgrades to accommodate the need to store cine clips. 

The change in ultrasound scan protocols has significantly improved the overall workflow environment both in objective time savings and subjective changes in  the perception and behavior of sonographers and sonologists.  On the average, examinations are 39 % faster with cine clips and have a projected potential increase of 20-25 % more examinations per day. Improvement in sonographer/sonologist/referring clinician communications are subjective measures but definitely observed.  Practical elimination of repetitive stress disorders is a major factor in improved sonographer behavior. 

The incorporation of cine clips in routine ultrasound scan protocols has proven positive impact on daily workflow.  The advantages of the new protocol outweigh disadvantages that may exist.

Bragg, A, Slaughter, A, Angtuaco, T, From Static Images to Cine Clips: Enhancing the Ultrasound Workflow Environment.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9010810.html