Emergency Magnetic Resonance Imaging 3-Tiered Prioritization

Area of Science:

• Medical Imaging
• Radiology
• Healthcare Management

Background:

• Traditional magnetic resonance imaging (MRI) prioritization methods are inadequate for emergency department (ED) patient volumes.
• Heterogeneous patient acuity in the ED requires effective risk stratification for MRI scheduling.
• Current systems fail to meet the varying urgency levels of ED patients needing MRI.

Purpose of the Study:

• To develop and implement a novel system for prioritizing MRI imaging for ED patients.
• To stratify ED patients based on illness severity to match MRI urgency.
• To improve the efficiency and timeliness of MRI scans for critically ill patients.

Main Methods:

• Implemented a 3-level tiered classification system (critical, emergent, urgent) for ED MRI orders.
• Defined clear clinical criteria and examples for each tier, linked to target order-to-imaging start times (OTST).
• Conducted a 1-year retrospective analysis of ED MRI order volume and OTST by tier.

Main Results:

• The tiered system successfully stratified ED patients by acuity, with only 4% classified as critical (tier 1).
• Tier 3 (urgent) examinations comprised 75% of the ED MRI volume.
• Average overall wait times for ED MRIs decreased from 245 minutes to 136 minutes, meeting target times.

Conclusions:

• A 3-tiered ED MRI ordering system based on patient severity is effective and unambiguous.
• The system's numerical hierarchy and clear definitions facilitate accurate prioritization.
• This approach improves expectation management for providers and patients regarding MRI turnaround times.