Top reasons for radiology workflow interruptions and how to address them
New research published Monday explores some of the top reasons for radiology workflow interruptions and how to address them.
Electronic communication platforms have helped transform contemporary radiology practices, allowing for communication between disparate teams. However, given increasing imaging volumes and the complexity of practice environments, these platforms potentially pose a threat to patient safety and physician well-being, experts write in Academic Radiology.
University of Wisconsin researchers recently analyzed the prevalence of these interruptions over a single year ending in July 2023. They discovered a high volume of electronic messages, likely leading to unnecessary disruptions.
“Organizational communication protocols could reduce workflow disruption for radiologists and technologists,” lead author Priya Loganathar, PhD—a human factors design engineer with the UW School of Medicine and Public Health at the time of the study, who is now with GE HealthCare—and colleagues concluded. “Optimizing [electronic communication platform] … protocols by time of day and message type could also improve workflow efficiency, ultimately enhancing patient safety and productivity. Future implementation of targeted interventions using these data is warranted.”
For the study, UW researchers analyzed all 39,000-plus WebEx messages sent across a single academic radiology practice in a year, focusing solely on CT-related requests. They also conducted interviews with technologists and resident physicians to determine context around these interruptions. They discovered the highest frequency of messages occurred between 7:30 a.m. to 4:30 p.m. (with about 4.2 per hour) and 4:30 to 9 p.m. (also 4.2).
Most frequently, communications covered questions about imaging protocols (13%), clarifications around allergies and contrast (7%), exam appropriateness, and patient complexity. A high volume of messages pertained to these CT-specific concerns, with “consistent activity throughout the workday.” Further analysis unearthed 24 “contextual factors” that influence electronic communication in the radiology department.
“This highlights that existing organizational factors—like the need for physician approval on change of scans, psychological safety, and perceived workload—play a role in the high number of messages that could lead to interruptions in both radiologist and technologist workflows,” Loganathar and co-authors noted. “Task factors such as unclear indications from ordering physicians also increase the communication needed via WebEx. These findings suggest that workflow gaps, knowledge limitations, and resource constraints are triggers for WebEx communication.”
Based on these findings, the study’s authors proposed three possible interventions to minimize electronic interruptions:
1. Communication standards: Developing and disseminating standards and etiquette for optimizing electronic communication platform use, with the hope of reducing unnecessary communication. About 40% of messages pertained to a dozen smaller topics, the study found, predominantly using informal words such as “lol” and “nvm.”
2. Holding workshops: Conducting workshops to enhance the radiology team’s communication skills and collaboration strategies, fostering a more “efficient and streamlined workflow.” This can help to minimize the need for reactive communication and promote more proactive information sharing, the authors noted.
3. Trust and safety: Promoting trust and psychological safety among radiologists and technologists also could help to increase the visibility of their work and create a better learning information.
“This is particularly critical as increasing study volumes and workload coupled with workforce shortages put a premium on efficient and rapid throughput,” the authors noted.
Future research could potentially explore other modalities outside of CT or test the effectiveness of implementing these solutions. Loganathar and colleagues also suggested conducting a follow-up study across multiple institutions with a larger sample size, enhancing the generalizability of their findings and providing a broader perspective on communication patterns.
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.