Use of CT angiography in the emergency department has produced a surge of extra work for radiologists and other staffers that warrants extra attention from imaging leaders.
That’s according to a new single-center analysis of trends in the delivery of computed tomography scans with contrast to view blood vessels and tissues. During the decade ending in 2015, Massachusetts General Hospital saw the number of radiologist recommendations tied to these exams increase in the ED rise from about 2% up to 29%. CTAs requiring verbal communication with referring providers increased from 9% up to nearly 25% at the same time, experts wrote Sunday in Current Problems in Diagnostic Radiology.
Despite growing workloads, average turnaround times for each study fell from about five and a half hours down to two hours and 19 minutes by 2015.
“The significant increase in interpretative and non-interpretative tasks combined with shorter turnaround time expectations can potentially lead to increasing workload-related distress among radiologists and other healthcare professionals,” Ali Pourvaziri, MD, with the Boston-based institution’s radiology department, and co-authors detailed Jan. 23. “Increased information generated per study also inadvertently increases radiologists' cognitive burden and workload. As radiology practices experience growing workloads without a subsequent increase in radiology staffing, the effects can be detrimental to radiologists' well-being due to an increased risk of potential burnout and dissatisfaction.”
For the study, Pourvaziri et al. retrospectively analyzed data on all adult patients who received CTAs of the aorta at their level 1 quaternary care hospital between 2005-2015. The search resulted in a sample of nearly 4,400 examinations on patients at an average age of almost 70. Mass General saw CTA use surge about 60% during the first two years of the study period, but no notable increases after that. Meanwhile, the proportion of exams with aortic findings did not significantly change during the study period, falling from 28% down to 25% by 2015.
The study’s authors believe the high number of images per study, coupled with a growing number of non-interpretive tasks, underline the need for smart staffing models to avoid overworking providers.
“Radiology departments should consider the increasing workload related to vascular imaging, especially those associated with major vascular care centers, as having a reasonable workload and workforce balance are essential to provide high-quality radiology care,” the authors advised. “Creating a data-driven, analytical understanding of the imaging volumes per shift can allow radiology practices to effectively increase the number of radiologists to handle higher volume of patients and meet turnaround time expectations in the ED setting. Radiology departments could also work to better understand the workload impact on additional reformatted series and increased number of images that may have limited value in improving diagnostic accuracy and consider establishing formal evaluation processes to continuously assess the diagnostic value and workflow impact of implementing new technologies.”
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.