Dustin Boatman MD, Presenter: Nothing to Disclose

Ryan Patrick McWey, Abstract Co-Author: Nothing to Disclose

Michael Hanshew MS, Abstract Co-Author: Nothing to Disclose

Cree Michael Gaskin MD, Abstract Co-Author: Research Consultant, Johnson & Johnson Author with royalties, Oxford University Press Author with royalties, Thieme Medical Publishers, Inc

Addition of a numeric reading priority system as a step beyond order priority for prioritizing radiology exam interpretation was associated with more desirable stratification of RTAT, as well as improved (reduced) variability in RTAT for high priority exams.

The prioritization of radiology exam interpretation is conventionally based upon the order priority set by the ordering provider. This may not allow for revision of priority based upon new information (e.g. pending clinic appointment or concerning imaging finding noted by the tech). It also yields competing priorities between inpt, outpt, and ED exams when folded into a common reading work list.

This QI project was not human subject research. Our institution implemented a numeric reading priority (1-9, with defined criteria) set by the tech at end exam in addition to the provider’s order priority. We sought to determine the impact of this additional priority score on stratified report turnaround time (RTAT) (i.e. time between end exam and release of first report). We retrospectively reviewed RTAT for all exams, excluding fluoroscopy, (n=309,331) parsed by read priority for the same 6 mos (Mar-Aug) at 2 points: immediately following implementation (when radiologists continued existing patterns of prioritization, largely ignoring the new data) and 1 yr later (after they had adopted prioritizing interpretations with the new read priority score).

With existing patterns of priority for interpretation, RTAT was not well stratified by hierarchical reading priority and demonstrated wider variation. Avg RTATs in hours(STD DEV) for all combined modalities, in order from most urgent (score 1) to least(score 9) were 11.9(6.1),4.7(6.9), 13.6(31.4), 11.8(59.7), 17.4(21.5), 14.9( 42.9), 28.8(13.8), 26.2(47.1), and 21.7( 27.7). After radiologists adopted use of the read priority score, RTATs for the same priorities were 1.7(4.2), 1.3(2.5), 6.5(15.6), 6.6 (17.1), 13.4(20.6), 10.1(11.9), 18.9(16.2), 18.8(28.9), and 18.2(27.5). The high priority studies had the greatest improvements with reduced and more uniform RTAT. Included FIGURE demonstrates improvement across all priorities but most notably among high priority studies.

Boatman, D, McWey, R, Hanshew, M, Gaskin, C, Implementation of a Numeric READING PRIORITY System as a Distinct Step beyond Conventional Use of ORDER PRIORITY for the Prioritization of Radiology Exam Interpretation: Impact on STRATIFIED REPORT TURNAOUND TIME in a Large Academic Medical Center.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13017924.html