Decreasing patient appointment waiting days for ultrasound diagnosis in Saint Peter Specialized Hospital: a quality...

Ultrasound examination turnaround time refers to the duration from when a clinician orders the test to when results are reported. In many public hospitals, limited workforce capacity, inefficient workflows and unstructured scheduling contribute to prolonged waiting times for diagnostic imaging. Timely ultrasound diagnosis is essential for appropriate clinical decision-making and patient flow. This project aimed to reduce excessive waiting times for ultrasound appointments in a high-volume public hospital METHODS: A Quality Improvement (QI) project was conducted in the Radiology Department of Saint Peter Specialized Hospital between August and November 2022. The aim was to reduce the median waiting time for ultrasound appointments from 28 days to less than 5 days. A root cause analysis (RCA) identified key contributors, including delayed start times, absence of structured scheduling, workflow interruptions and limited machine availability. Driver diagrams and prioritisation matrices informed intervention selection and tested through sequential Plan-Do-Study-Act (PDSA) cycles. Interventions included workflow optimisation, extended effective working hours, productivity enhancement, structured appointment scheduling and deployment of point-of-care ultrasound for emergency cases.

The maximum waiting time for senior radiologist ultrasound appointments decreased from 28 days to ≤5 working days. The backlog for technologist-led examinations was eliminated. Daily productivity increased from 10 to 48 scans per radiologist and from 18 to 65 scans per technologist. Run charts demonstrated progressive and sustained improvement across four PDSA cycles.

The QI project achieved significant reductions in ultrasound waiting times through organisational and workflow redesign without additional funding. Sustainability relied on staff engagement, leadership support and embedding new practices into routine operations. These low-cost, context-appropriate strategies may be applicable to other resource-constrained hospitals facing similar challenges.