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Published on: July 16, 2015
Workflow Interruptions and Effect on Study Interpretation Efficiency
Summit H Shah1, Lamya A Atweh1, Corey A Thompson2
1Nationwide Children's Hospital, Columbus, OH.
Background:
Interruptions have been shown to adversely impact efficiency, accuracy, and patient safety.
Objective:
To analyze the frequency and types of interruptions and effect on report interpretation efficiency.
Materials And Methods:
A business process improvement team was consulted to make detailed recordings of the activities of the radiologists. Activities were categorized as interpreting studies, active interruptions initiated by the radiologist, and passive interruptions initiated by an external source.
Results:
Thirteen board-certified, pediatric radiologists were observed for 61 hours. Radiologists spent 52% of their time interpreting studies, 29% on active interruptions, and 18% on passive interruptions. Approximately 50% of non-interpretive time involved in-person conversations or consults and 16% involved phone calls of which 67% were incoming. The longest time period without an interruption was 20 minutes. 85% of the time, an interruption came within 3 minutes of beginning an interpretation and lasted 1 minute or less 70% of the time. Interruptions increased the time a radiologist needed to read a study by 1 minute for radiographs, 2 minutes for ultrasounds, 6 minutes for CTs, and 10 minutes for magnetic resonance imaging.
Conclusion:
Total interruption time nearly equaled the total time interpreting studies for radiologists, and interruptions decreased efficiency and increased report interpretation times for all modalities studied. This study highlights the type and extent of interruptions in radiology and examines the effect on report interpretation times. With the frequency of interruptions and impact on efficiency, there is a need to dedicate resources to manage the radiologist workflow. Strategic interventions may ultimately improve outcomes, efficiency, and the overall work environment.
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