Subspecialized Radiological Reporting Expedites Turnaround Time of Radiology Reports and Increases Productivity

Abstract

Introduction To assess the impact of changing from general to subspecialized reporting on turnaround time of radiology reports (TAT), the fraction of radiology reports available within 24 hours (R< 24 h) and productivity.

Materials and Methods Reporting workflow in our radiology department was changed from general reporting (radiologists report imaging studies of all areas [neuroradiological, abdominal, musculoskeletal imaging et cetera]) to subspecialized reporting (radiologists solely report imaging studies of their subspecialty field [e. g. musculoskeletal]). TAT, R< 24 h and productivity were calculated for a 12-month period of general reporting (January-December 2012) and compared to a 12-month period of subspecialized reporting (April 2014-March 2015) using Mann Whitney U-test, Pearson chi-square test and odds ratios, respectively.

Results Report TAT decreased from a median of 17:04 hours (h) during general reporting to 3:38 h during subspecialized reporting, resulting in a 4.7-fold improvement (p < 0.001). R< 24 h improved significantly from 65 % to 87 % (p < 0.001). The odds of a radiology report being available < 24 h was 3.6- fold higher during subspecialized compared to general reporting. Productivity increased from a median of 301 to 376 (reports/full-time radiologist/month) (p = 0.001).

Conclusion Changing the workflow from general to subspecialized reporting significantly improved the turnaround time of radiology reports, the fraction of radiology reports available within 24 hours and productivity.

Key Points: 

• Changing the radiology reporting workflow from general to subspecialized reporting is feasible.

• Implementation of subspecialized reporting yielded significant improvement of radiology report turnaround time.

• Implementation of subspecialized reporting substantially increased the fraction of radiology reports available < 24 h.

• Radiologists’ productivity increased after changing to subspecialized reporting.

Citation Format

• Stern C, Boehm T, Seifert B et al. Subspecialized Radiological Reporting Expedites Turnaround Time of Radiology Reports and Increases Productivity. Fortschr Röntgenstr 2018; 190: 623 – 629

Zusammenfassung

Einleitung Untersucht wurde die Auswirkung eines Wechsels von allgemeiner zu subspezialisierter Befundung auf die Befunddurchlaufzeit radiologischer Berichte (TAT), den Anteil der innerhalb von 24 Stunden freigegebenen radiologischen Berichte (R< 24 h) und die Produktivität.

Material und Methoden Der Befundungsworkflow in unserer Radiologieabteilung wurde von allgemeiner Befundung (Radiologen befunden Bilduntersuchungen aus allen Bereichen [neuroradiologische, abdominale, muskuloskelettale Radiologie etc.]) auf subspezialisierte Befundung (Radiologen befunden ausschließlich Bilduntersuchungen aus ihrem subspezialisierten Fachgebiet [z. B.: muskuloskelettale Radiologie]) umgestellt. TAT, R< 24 h und Produktivität wurden für 12 Monate (Januar-Dezember 2012) allgemeiner Befundung berechnet und verglichen mit einer Periode von 12 Monaten (April 2014-März 2015) subspezialisierter Befundung unter Verwendung von Mann-Whitney U-Test, Pearson Chi-Quadrat-Test und der Quotenverhältnisse.

Ergebnisse Die Befunddurchlaufzeit reduzierte sich von median 17:04 Stunden (h) während allgemeiner Befundung auf 3:38 h während subspezialisierter Befundung, was in einer 4,7-fachen Verbesserung resultierte (p < 0,001). Der Anteil der innerhalb von 24 h freigegebenen radiologischen Berichte verbesserte sich signifikant von 65 % auf 87 % (p < 0,001). Die Chance eines radiologischen Berichtes innerhalb von 24 h freigegeben zu werden war während subspezialisierter Befundung 3,6-fach höher im Vergleich zu allgemeiner Befundung. Die Produktivität verbesserte sich von median 301 auf 376 (Befundberichte/Vollzeitradiologe/Monat) (p = 0,001).

Schlussfolgerung Ein Wechsel des Workflows von allgemeiner zu subspezialisierter Befundung verbesserte signifikant die Befunddurchlaufzeit radiologischer Berichte, den Anteil der innerhalb von 24 Stunden freigegebenen radiologischen Berichte und die Produktivität.

Kernaussagen: 

• Ein Wechsel des radiologischen Befundungsworkflows von allgemeiner zu subspezialisierter Befundung ist praktikabel.

• Die Implementierung subspezialisierter Befundung erbringt eine signifikante Verbesserung der radiologischen Befunddurchlaufzeit.

• Die Implementierung subspezialisierter Befundung verbessert substantiell den Anteil der innerhalb von 24 h freigegebenen radiologischen Berichte.

• Die Produktivität der Radiologen verbesserte sich nach dem Wechsel auf subspezialisierte Befundung.

Key words

report turnaround time - subspecialized reporting - report availability - reporting workflow - productivity

• References

• 1 Boland GW. Voice recognition technology for radiology reporting: transforming the radiologist’s value proposition. Journal of the American College of Radiology: JACR 2007; 4: 865-867
• 2 Boland GW. Stakeholder expectations for radiologists: obstacles or opportunities?. Journal of the American College of Radiology: JACR 2006; 3: 156-163
• 3 Zhang L, Hefke A, Figiel J. et al. Identifying radiological needs of referring clinicians. Journal of digital imaging 2013; 26: 393-401
• 4 England E, Collins J, White RD. et al. Radiology report turnaround time: effect on resident education. Academic radiology 2015; 22: 662-667
• 5 Liebscher L, Sherry C, Breslau J. et al. The general radiologist in the 21st century. Journal of the American College of Radiology: JACR 2012; 9: 554-559
• 6 Smith GG, Thrall JH, Pentecost MJ. et al. Subspecialization in radiology and radiation oncology. Journal of the American College of Radiology: JACR 2009; 6: 147-159 e144
• 7 Breil B, Fritz F, Thiemann V. et al. Mapping turnaround times (TAT) to a generic timeline: a systematic review of TAT definitions in clinical domains. BMC medical informatics and decision making 2011; 11: 34
• 8 Hastie T. gam: Generalized Additive Models. R package version 1.12. 2015 [cited 2016 2016.01.30]. Available from: http://Cran.R-project.org/package=gam
• 9 Krishnaraj A, Lee JK, Laws SA. et al. Voice recognition software: effect on radiology report turnaround time at an academic medical center. Am J Roentgenol American journal of roentgenology 2010; 195: 194-197
• 10 Prevedello LM, Ledbetter S, Farkas C. et al. Implementation of speech recognition in a community-based radiology practice: effect on report turnaround times. Journal of the American College of Radiology: JACR 2014; 11: 402-406
• 11 Mehta A, Dreyer K, Boland G. et al. Do picture archiving and communication systems improve report turnaround times?. Journal of digital imaging 2000; 13: 105-107
• 12 Akhtar W, Ali A, Mirza K. Impact of a voice recognition system on radiology report turnaround time: experience from a non-english-speaking South Asian country. Am J Roentgenol American journal of roentgenology 2011; 196: W485 ; author reply 486
• 13 Rosenkrantz AB, Bonavita JA, Foran MP. et al. Is there an association between radiologist turnaround time of emergency department abdominal CT studies and radiologic report quality?. Emergency radiology 2014; 21: 5-10
• 14 Zan E, Yousem DM, Carone M. et al. Second-opinion consultations in neuroradiology. Radiology 2010; 255: 135-141
• 15 Eakins C, Ellis WD, Pruthi S. et al. Second opinion interpretations by specialty radiologists at a pediatric hospital: rate of disagreement and clinical implications. Am J Roentgenol American journal of roentgenology 2012; 199: 916-920
• 16 Sickles EA, Wolverton DE, Dee KE. Performance parameters for screening and diagnostic mammography: specialist and general radiologists. Radiology 2002; 224: 861-869
• 17 Bell ME, Patel MD. The degree of abdominal imaging (AI) subspecialization of the reviewing radiologist significantly impacts the number of clinically relevant and incidental discrepancies identified during peer review of emergency after-hours body CT studies. Abdominal imaging 2014; 39: 1114-1118