Giles Walter Boland MD, Presenter: Nothing to Disclose

Dianne Whelton, Abstract Co-Author: Nothing to Disclose

Reducing RTAT from examination completion to final staff signature is considered an important quality metric by radiology stakeholders. Therefore, in an attempt to improve this patient care metric, a large teaching hospital introduced a pay-for-performance measure in an attempt to reduce RTAT. This paper evaluates the impact on RTAT of this strategy.

Mean RTAT for 98 radiologists (10 sub-specialty divisions) was measured for the 3 months before introduction of a pay-for-performance initiative and for 15 months after. Measurements included the time from examination completion (C) to preliminary report availability (P) by resident or fellow, and the time from preliminary (P) to final staff signature (F). Dictation was performed using voice recognition software. C to P and P to F times were measured in hours directly from the RIS. The pay-for-performance initiative withholds a financial bonus for those not meeting institutional RTAT guidelines. The RTAT goal varied according to type of divisional practice (i.e. ER 2 hr. vs. neuro-interventional radiology 24 hr.).

A total of 976259 reports were analyzed. Mean C to P for all reports for the total period reduced from 20 hours (range 2.8-86 hrs) to 9.6 hours (range 0.4-24 hrs). Mean P to F reduced from 31 hours (range 2-144 hrs) to 3.4 hours (range 1-31 hrs) (P = 0.0001). Mean total RTAT (C to F) steadily reduced from 55 to 13 hours over 12 months after which the RTAT stabilized at its nadir. Twelve of 98 staff radiologists failed to meet the RTAT guidelines. The mean RTAT for all 10 subspecialty divisions met the RTAT guidelines.

Initial experience with pay-for-performance measures demonstrates a significant impact in helping to reduce RTAT. The impact was most profound for preliminary to final report signoff where RTAT was reduced by more than 24 hours.

Pay-for-performance measures may help reduce radiology RTAT due to a combination of incentives and peer pressure to meet institutional expectations.

Boland, G, Whelton, D, Reducing Radiologist Report Turnaround Times (RTAT): Impact of Pay-for-Performance Measures.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6015174.html