A pilot study of time allocation and reimbursement for routine obstetric ultrasonography

To evaluate time allocation during initial and repeated ultrasonography and to formulate recommendations to improve unit efficiency.

Over a 2-year period, 51 comprehensive ultrasonographic examinations between 14 and 38 weeks' gestational age were observed by a single reviewer. Each patient-sonographer interaction was divided into timed segments, including setup, examination time, review, and turnover. Statistical analysis using descriptive statistics, Student ttest, and analysis of variance was performed to determine the effect of the number of ultrasonographic examinations, sonographer experience, estimated gestational age, and patient body mass index on examination time.

The average time spent with each patient was 15 minutes 22 seconds: 2 minutes 10 seconds for setup, 9 minutes 38 seconds for examination, 1 minute 50 seconds for review, and 1 minute 44 seconds for turnover. Examination length was not significantly affected by estimated gestational age, body mass index, ultrasonography experience, or the number of ultrasonographic examinations (P > .05). No statistical significance in the duration of scanning was found between initial (15 minutes 3 seconds) and repeated (16 minutes 1 second) examinations (P = .609). Nonexamination activities, such as data entry and room cleanup, consumed 37% of the sonographer's time.

Resource use within the ultrasonography department may be improved by reassigning clerical and custodial duties from sonographers to other personnel. Although differential reimbursement exists, no statistically significant difference in resource use between initial and repeated examinations was found.