How a radiology department drastically reduced incoming calls from rest of hospital
A radiology department is detailing how it drastically reduced incoming calls from the rest of its hospital.
Such check-ins can serve as a major source of workflow interruption and inefficiency, experts write Thursday in the Journal of the American College of Radiology. For busy rads, frequent phone calls can lead to distraction, fragmented task performance and burnout.
Leaders with the Royal Melbourne Hospital in Australia have aimed to address these interruptions through a targeted intervention. The effort has included an electronic medical record-integrated chat platform, alongside focused referrer education initiatives.
Comparing workflow metrics across 20 matched weekdays before and after implementation showed promising results. Telephone call volume to the radiology department dropped 55%, with all communication (including written messages) falling by 43%.
“Chat messages were reviewed and answered in a timely manner,” lead author Subhashaan Sreedharan, MD, MPH, with the Department of Radiology at Royal Melbourne, and colleagues concluded. “These findings support a scalable strategy to reduce communication-related interruptions in high-volume radiology departments.”
During regular business hours, a single trainee serves as the duty radiologist for the department, the authors noted. This individual is tasked with triaging and protocoling imaging requests and serves as the primary point of contact for referring clinicians and departmental staff. Phone calls and chat messages are received directly by the duty radiologist without any prior triage from administrative staff.
To help ease the burden on this individual, the hospital utilized Epic Secure Chat, an asynchronous messaging function integrated with the vendor’s EMR offering. Unlike traditional paging or phone calls, the platform allows clinicians to respond when it is clinically appropriate while maintaining a documented communication trail and minimizing task interruptions. Since it is intended for nonurgent communication, a formal response-time requirement is not prespecified.
Royal Melbourne paired the chat function with targeted referrer education. Teachings included an institution-wide email distributed to referring docs, outlining the new communication pathway. Educational sessions also were incorporated into orientation programs for new interns, residents and follows to introduce and encourage the use of the chat platform to contact the duty radiologist. Plus, the hospital handed out written guidance on the system within institutional resources and guidebooks.
“The key aim of the referrer education materials was to inform referrers that they do not need to contact the duty radiologist for routine protocoling requests,” the authors noted. “And that requests containing adequate clinical information, and a clear clinical question, would be reviewed and protocoled within an appropriate timeframe without requiring additional contact by telephone call or chat,” they added.
Median daily phone calls to the duty radiologist fell from 181 down to 82 after the intervention. When including text messages, total communication events fell from 181 per weekday to 104. At the same time, the number of studies protocoled was unchanged (at 92 per day vs. 97). This while maintaining a median time-to-read of 8 minutes and time-to-reply of 14 minutes.
“Together, these findings suggest that a structured transition from synchronous to asynchronous communication can reduce potentially disruptive communication events while maintaining protocolling throughput,” the authors wrote. “In the setting of rising imaging demand and increasing pressure on radiology services, such interventions may represent a practical strategy to improve efficiency and reduce unnecessary interruptions,” they added later.
Read more, including potential study limitations, in the Journal of the American College of Radiology.
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.