ED pivots to virtual radiology service, slashing CT turnaround times and lengths of stay
An academic medical center is detailing how a pivot to a new virtual radiology service helped it slash CT turnaround times while also reducing patients’ time spent in the hospital.
Syracuse, New York-based Upstate Medical University’s trauma service mandates that radiologists finalize CT interpretations prior to patient discharge. However, during evening and overnight hours, rad residents frequently handle initial interpretations, with an attending radiologist’s final read delayed until the morning, researchers detailed in the Annals of Emergency Medicine.
But this approach often can hinder patient throughput and prolong hospital stays, leading to additional healthcare costs. To address this, the university has implemented a new virtual radiology service between 8 p.m. and 4 a.m., utilizing teleradiologists to immediately handle CT reads, rather than waiting until the morning.
“The implementation of virtual radiology services during overnight hours was associated with a significant reduction in turnaround time and a concurrent decrease in emergency department length of stay,” Sanskruti Kakaria, DO, an EM resident, and co-authors wrote for a study presented at the ACEP Research Form, held Sept. 7–10 in Salt Lake City. “While these findings suggest a positive impact on patient flow and trauma throughput, further analysis is needed to determine whether the observed improvements are causally linked or influenced by other confounding factors.”
Their study evaluated turnaround times for CT brain and spine imaging Level 1 and 2 trauma patients across two six-month intervals. The first covered the half-year leading up to the new program while the second charted results after implementation. To isolate impact on discharge efficiency, only patients who were not admitted to the hospital were included. TAT was defined as the interval from CT scan completion to final interpretation by an attending radiologist.
Implementation of the new virtual radiology services was associated with a statistically significant reduction in both turnaround times and ED lengths of stay, the authors found. For all four CT scan types analyzed—including head and cervical, thoracic and lumbar spine—TAT was “significantly shorter” after implementation. In addition, the average length of stay for trauma patients dropped from 615 minutes prior to the intervention to 487 minutes afterward, also a statistically significant change. Across both time periods, the consulting service was independently associated with increased length of stay. But no noteworthy differences in LOS were observed based on turnaround time, number of scans performed, method of arrival or trauma level, the authors concluded.
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.