How to safely and significantly decrease breast MR wait time

Researchers from the University of Michigan may have found a way to significantly decrease MRI wait time while maintaining high image quality that can be applied to other practices, according to a study published April 4 in the Journal of the American College of Radiology

Long wait times for any MRI can increase anxiety and frustration, which may contribute to delayed diagnosis and loss of revenue, according to the researchers led by Colleen Neal, MD, associate professor of radiology at the University of Michigan. Additionally, certain U.S. states requiring government-issued certificates of need to access CT and MRI services also contribute to the issue. 

Neal and colleagues conducted a quality improvement initiative from December 2014 to March 2016. Researchers then reviewed breast MRI wait times biweekly, as well as scheduling grids and staffing models. To verify image quality, researchers analyzed 20 randomly selected breast images per month for 16 months to evaluate. 

The researchers found that within the first three months of the study, the small number of MR technologists trained to perform breast exams and required physician monitoring contributed to long breast MR wait times. In response, Neal and colleagues trained additional breast MR technologists selected under careful proficiency review to work evenings and weekends and completely removed the requirement for direct physician monitoring. 

Because of these efforts, overall wait time for a routine breast MRI fell from 101 days to five, with 798 breast MRI examinations performed during the entire study period and a monthly volume increase of 43 percent. Additionally, image quality was maintained for the entire study, including three percent major diagnostic impairment rate and 0.5 percent prospective breast MR technical recall rate, the researchers wrote. 

"Timely access to medical imaging is necessary to ensure optimum patient and referring provider satisfaction," the researchers wrote. "A structured checklist- driven technologist training plan coupled with side-by- side mentoring by experienced technologists were effective countermeasures for our initially long wait times. This model may be useful for transitioning newly implemented advanced diagnostic imaging examinations into routine clinical practice."