Phone calls biggest noninterpretive expanders of rad-report turnaround times

In emergency radiology, the price radiologists pay for taking every phone call that comes in during a read—and then taking the time to hear out each caller—is racking up slower report turnaround times. No surprise there, but a new study shows the total duration of such phone calls within an hour to be the single most telling turnaround-time predictor among all tasks that take ED rads away from their overnight reads.

That’s according to a study focused on emergency neuroradiology, conducted at Massachusetts General Hospital and published online Sept. 13 in the Journal of the American College of Radiology.

McKinley Glover IV, MD, MHS, and colleagues found that, for every 1-minute increase in total duration of calls in an hour, mean radiology report turnaround time increased by 4.25 minutes.

They also found academic neuroradiologists spend more time than they likely realize engaged in various noninterpretive tasks.

The authors suggest that standardizing capture of these off-read tasks “may aid development of strategies that address productivity, communication and value in radiology.”

For the study, Glover and team retrospectively analyzed a week’s worth of data reflecting 63 hours of overnight neuro coverage.

They further found the mean number of phone calls taken per hour was 8.7, while mean duration of phone calls per hour was 12 minutes, with a range of 1 minute to 46 minutes.

The mean number of reading-room badge swipes per hour—an incomplete but important indicator of referrers entering the reading room for face-to-face consultation—was 2.1, while the mean number of CT and MRI exams performed per hour was 2.2.

In their discussion, the authors note that their work quantifying the impact of noninterpretive tasks on workflow builds on previous research showing a correlation between fielding phone calls while reading exams and making interpretive errors among on-call radiology residents.

“Radiologists, technologists and referring providers should engage in thoughtful discussion regarding optimizing workflow and communication to minimize non-value-added noninterpretive tasks,” they write. “Leveraging nonclinical support staff or medical students to triage phone calls may be opportunities to shift nonvital communication to an appropriate level of training.”

Commenting on their findings on reading-room badge swipes by referring clinicians, Glover and colleagues note the centralized location of their neuroradiology reading room within the ED. The room is specifically situated, they point out, to promote in-person communication between radiologists and providers.

“Typical consultations include review of outside imaging studies, answering questions on imaging protocols, clarifications of interpretations and providing input regarding further patient management,” they write. “These high-value tasks give radiologists an important role in team-based care and have the potential to increase quality through optimization of appropriate imaging and elimination of unnecessary follow-up imaging studies. Departments and practices may benefit from developing standardized processes to better capture and not deincentivize face-to-face communications.”