EMR-based framework produces 30% reduction in overnight CT report turnaround times
An academic medical center struggling to meet CT report turnaround time (TAT) benchmarks was recently able to improve its overnight efficiency by implementing an electronic medical record-based framework designed to streamline teleradiology requests.
In a new paper in Emergency Radiology, experts from the Department of Emergency Medicine at Oregon Health & Science University shared how their organization was able to improve CT report turnaround times amid an increase in imaging demand. Prior to implementing a number of initiatives, the department’s CT turnaround times exceeded national benchmarks; the authors contend this was due to delays occurring during the time between radiology residents’ initial reads and outsourced attending-level radiologists’ final interpretations.
“Emergency departments across the United States are facing unprecedented patient volumes and overcrowding, amplifying the need to optimize throughput and operational efficiency. Computed tomography turnaround time is the interval from imaging order to interpretation, and this represents a key determinant of ED flow,” Obert Xu, MD, and colleagues noted. “Our objective was to reduce the interval between preliminary resident interpretation and teleradiology service request by 25% through targeted workflow redesign and implementation of iterative quality improvement interventions.”
The initiative took place over three years and was implemented in four Plan-Do-Study-Act cycles designed to enhance communication between ordering providers, support staff and radiologists. The first phase involved introducing imaging order code phrases to indicate discharge intent; the second phase involved integrating automated work list-based referrals into the EMR, while the third added an EMR-integrated teleradiology request column on the ED tracking board; for the final phase, the team incorporated a radiology-initiated digital “Request Nighthawk Read” button that allowed residents to quickly submit exams for interpretation.
During the study period, over 12,000 patients underwent overnight CT scans in the ED, giving experts ample data to gauge the framework’s effectiveness. Pre- and post-intervention metrics indicated that the changes resulted in a 29.2% reduction in the median interval between residents’ preliminary reads to their teleradiology overread requests, decreasing from 30.5 minutes to 21.6 minutes. Turnaround times improved as well, dropping from 157.3 minutes to 130 minutes, while CT exam completion-to-result time decreased from 84.2 minutes to 72.6 minutes.
Overall, the updates were well received. The group reported improved communication and transparency among those involved in radiology workflows.
“This intervention provides a reproducible, low-cost strategy for similar academic institutions that employ dual resident-led and teleradiology overnight workflows,” the authors concluded.
Read more about the intervention here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.