Radiology residents face an average of about 46 interruptions (or three per hour) during one night shift, according to new research published in JACR [1].
Meanwhile, those working over weekends experience about 76 total interruptions, or roughly 1.5 each hour. “Protocol requests” are the most common type of disturbance, with an average of 24 occurring on weeknights and 28 each night shift.
The findings were derived from a recent practice improvement project executed within the University of Iowa’s Department of Radiology.
“Previous studies have documented the adverse impact of telephone interruptions, among other workflow disruptors, for on-call radiologists,” Bruno Policeni, MD, MBA, director of the Iowa City-based institution’s neuroradiology fellowship program, and colleagues wrote Feb. 17. “The purpose of this study was to characterize the type and frequency of interruptions to radiology resident workflow during after-hours weeknight and weekend call, and to survey residents on their perception of reading room coordinators’ effect on workflow.”
Iowa hired someone to fill such a position in 2021, tasking them with triaging pages from clinical teams, answering phone calls, and facilitating protocol requests for imaging studies. Paid medical student externs pitched in to help supplement reading room coordination shifts, “mirroring the resident call schedule,” the authors noted. Policeni et al. distributed a spreadsheet among coordinators to help track the number of interruptions each shift.
During a four-week period in summer 2022, there were a total of 827 interruptions to resident workflows, including calls from referrers, questions on radiological exams, file management queries, and requests to protocol cross-sectional imaging studies. During 13 weekday overnight shifts (5 p.m. to 8 a.m.) included in the study, there were 600 interruptions (or 46 per night). In the sampled six weekend shifts (three Saturdays and three Sundays), there were 227 interruptions (76 on average).
Reading room coordinators were able to effectively communicate urgent protocol requests such as code-stroke studies, the authors noted. However, all contrast-enhanced, cross-sectional exams were batch-communicated to residents to protocol between exams, minimizing interruptions during dictations. In follow-up surveys, two-thirds of residents agreed or strongly agreed that coordinators were integral to relaying critical results, fielding phone calls and facilitating workflows that minimized disruption. About 95% strongly agreed on coordinators’ crucial role in file management.
“This is particularly useful at our institution as we frequently accept trauma, and critically ill transfer patients from smaller referring hospitals within a 250-mile catchment area, and transferring DICOM images to our PACS is a laborious task,” the authors reported.
Read further details on the study, including potential limitations, at the link below. Dutch imaging experts also recently shared a similar study on the use of reading room assistants in the European Journal of Radiology [2]. And Policeni published a separate study about coordinators in September.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.