Nicholas Vernace BS, Abstract Co-Author: Nothing to Disclose

Josiah W. Bancroft MD, Abstract Co-Author: Nothing to Disclose

Ronald Scott Shill MD, Abstract Co-Author: Nothing to Disclose

Ronald Drachenberg BS, Abstract Co-Author: Nothing to Disclose

Warren Wylie, Abstract Co-Author: Nothing to Disclose

Laura W. Bancroft MD, Presenter: Royalties, Wolters Kluwer nv

Radiology turnaround times can be markedly improved by assuming ownership and addressing inefficiencies in the various segments defining PAEC and ECRA.

Radiology Department (RD) turnaround times (TAT) are continuously scrutinized by the entire medical team. At our institution, radiologist interpretation times were historically cited as the primary source of delayed treatment and discharge of Emergency Department (ED) patients. A change in radiologists and governance structure in 2008 prompted a systematic improvement in imaging TAT in the ED.

1st part of our study evaluated "Patient Arrival to Exam Complete" (PEAC) time at baseline and after process implementation that improved system efficiencies. Patient Ready Project was initiated at 7 Hospital campuses in step-wise fashion 9/2010-3/2012. In first quarter (Q1) of 2008, baseline TAT from PAEC averaged 229 minutes for 26,335 ED CT scans. During Q1 of 2012, PAEC time dropped to 105 min. avg. One year after Patient Ready implementation, communication/logistics between the ED and RD significantly improved through series of checklists. Avg. PAEC was 110 min. in Q4 of 2013 despite 26% increase in CTs to 33,280. 2nd part of the study evaluated "Exam Completion to Report Available" (ECRA) time at baseline and after intervention increasing radiologist productivity (reorganized PACS worklists, voice recognition templates, incentives, swing shifts matching radiologist and study volumes). ECRA in Q1 of 2008 averaged 74 min, steadily decreased from 2008 to 2013, and averaged 15 minutes in Q4 of 2013. However, improved Radiology TAT did not yield an equivalent decrease in time to discharge from the ED.  

Overall time from patient arrival to discharge from the ED proved to be partly, but not solely, dependent upon radiology department functionality. Individual components of system-wide and radiologist-dependent processes were dissected in order to understand deficiencies and extract maximal benefit. Through this two part endeavor, turnaround times of CT studies arriving at the PACS station decreased 52% over 5 years, and Radiologist time decreased by 80%. Interestingly,  these improvements did not yield a direct correlation with time to discharge from the ED.

Vernace, N, Bancroft, J, Shill, R, Drachenberg, R, Wylie, W, Bancroft, L, Computed Tomography Turnaround Times in the Emergency Department: Radiologist Productivity and "Patient Ready Project" Will Make You Turn Around.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002168.html