Kathy Tabor-McEwan BA, Presenter: Nothing to Disclose

Mary-Theresa Shore, Abstract Co-Author: Nothing to Disclose

Lori-Ann Thwing BS, Abstract Co-Author: Nothing to Disclose

Prerna Singh Kahlon, Abstract Co-Author: Nothing to Disclose

Robert Arthur Novelline MD, Abstract Co-Author: Nothing to Disclose

The transition from Analog to Digital imaging utilizing PACS has revolutionized the speed of delivering studies to the radiologist while at the same time creating errors in images related to inconsistent workflow processes. The purpose of this study was to measure the decrease in errors and improvement of quality in imaging studies through the implementation of a consistent workflow process, and quality check.

A workflow analysis was carried out on emergency radiology technologists performing MRI, CT, Ultrasound and General Radiography with attention on workflow that affected transmitting images to PACS and the radiologist. Using this analysis we categorized issues into Image Quality and Data Integrity. There were six error classifications in the category of imaging (positioning, technique, protocols, demographics, proper labeling, completion report)and five error classifications (cancelled exam, mis-labeled, merged, mis-identified, mis-scheduled) in the category of data integrity. Three months of data was collected and categorized prior to the implementation of process workflow changes, and three months of data was collected and categorized post implementation.

33,761 imaging studies were performed over a six-month period in Emergency Radiology. Prior to implementing consistent workflow 161 imaging errors occurred spread over six classifications and 150 data integrity errors occurred spread over five classifications for a total of 301 errors (0.01% of imaging studies). Post implementation of a consistent workflow process errors decreased by 52%, to 45 imaging errors and 65 data integrity errors for a total of 110 errors (0.007% of imaging studies) Man hours spent fixing errors (i.e. broken studies) decreased by 50%, from 89 man hours to 43 hours. This decrease in errors reduced Managers, Technologists and PACS analysts’ time in fixing errors.

Creating a consistent process by which technologists enter data at the imaging modality, perform the imaging study and then quality check prior to sending to PACS, improves image quality, and decreases errors and rework, which benefits patient care.

Tabor-McEwan, K, Shore, M, Thwing, L, Kahlon, P, Novelline, R, Improvement Model in the Digital Radiology Department.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4419581.html