How a Michigan practice cut its MRI wait times from 101 days to 5

As radiology practices grapple with the specialist shortages and drawn-out wait times that accompany a nationwide push for more specialized MRI, one Michigan practice is successfully solving both problems.

University of Michigan researchers based at the college’s Ann Arbor, Michigan, health system were able to reduce MRI wait time from 101 days to just five between December 2014 and March 2016. The practice also increased its number of trained breast MRI technologists to deal with additional deficits during off-hours.

First author Colleen H. Neal, MD, and colleagues wrote in the Journal of the American College of Radiology that breast MR volume among women increased 16-fold in some areas of the U.S. between 2000 and 2011. By 2014, they said, the University of Michigan was experiencing a similar surge, and wait times for breast MRIs were exceeding three months.

“This was problematic because delays in imaging have negative ramifications, including heightened patient anxiety, patient and referring physician frustration, delayed diagnosis, loss of revenue and lower patient satisfaction scores,” Neal and co-authors wrote. “In light of these issues, ready access to imaging has become a key performance indicator for radiology departments.”

The team undertook a quality improvement initiative late in 2014, tracking breast MR wait times on a weekly basis while they recorded root causes of lengthy wait times and kept note of scheduling grids and staffing models.

A total 798 breast MR exams were conducted during the study period, the research stated. Between baseline and the trial’s conclusion, breast MR volume increased from 23 exams per month to 50—and wait times fell by an average 96 days.

Neal et al. said they based their model around two key causes they identified as roots of the waiting problem: a paucity of both MR technologists and the radiologists assigned to monitor them.

“Both processes had been created to ensure high reliability of the newly implemented test but led to an inability to add examinations to the schedule grid after 5 p.m. or on the weekends when personnel were not available,” the authors wrote. “We then developed countermeasures to remove the requirement for direct physician monitoring and to train additional technologists for the afternoon, evening and weekend shifts.”

This approach worked, they said, and carved a path for better patient access to breast MR exams while maintaining image quality and service.

“We transitioned a specialized MR examination into routine clinical operation while substantially improving access, maintaining image quality and engaging staff,” Neal and colleagues said. “This model may be useful for transitioning newly implemented advanced diagnostic imaging examinations into routine clinical practice.”