Reengineering a radiology department in an academic institution

A 1-year program was undertaken in conjunction with an outside consultant to cut nonphysician labor expenses by 15%, cut nonlabor expenses by 10%, and improve all service parameters in an academic radiology department.

A steering committee decided on five major goal teams: improve report turnaround time and improve patient throughput, increase the efficiency of performance and improve the quality of radiologic examinations, decrease the cost of each examination, improve charge capture, and improve the perception of the department. The goal teams met at least every 2 weeks, made presentations to the steering committee at midyear, and were then disbanded. The steering committee implemented changes in the second half of the year and continues to meet every 2 weeks. Data were obtained from the radiology information system, financial statements, and surveys.

In the first year, report turnaround time decreased from 157 hr to 83 hr (and to 46 hr at 2 years), the efficiency of performing examinations (according to our criteria) improved from 64% to 80%, the quality of examinations improved, labor costs were reduced by 5% (and by 11% at 2 years), nonlabor costs were reduced by 14% (and by 31% at 2 years), cost per examination was reduced by 10% (and by 16% at 2 years), increased charge capture resulted in an annual increase in professional fees of at least $110,000, and the perception of the department by referring clinicians improved.

It is possible to simultaneously cut expenses and improve service. To gauge progress, objective parameters that can be measured easily are necessary.