A new study from the Thayer School of Engineering at Dartmouth, analyzed data from Lahey Hospital & Medical Care in Burlington, Massachusetts, in order to discover the most common causes of delay in outpatient MR scanning, and uncovered effective techniques for improving efficiency.
"Two of the most important factors in our case study were patient arrival patterns and exam procedure durations," first author Yifei Sun, a Dartmouth engineering Ph.D. candidate, told HCB News via email. "If a significant number of patients arrive later than scheduled, all the later exams will be postponed. If the procedure durations are often longer than the slot time, then the wait time will keep increasing throughout the day."
It is a common practice among hospitals to subordinate outpatient radiology exams, such as CT and MR scanning, to the typically more urgent needs of inpatient care, resulting in longer outpatient wait times. However, it has been previously established that other process and scheduling problems may also contribute to longer wait times.
For instance, a prior study concluded that improvements in streamlining the processes and communication between nursing staff and radiology technologists can decrease patient wait times
for CT scans by more than 50%.
Though a disparity between inpatient and outpatient wait times is prevalent across various radiological imaging modalities, reducing outpatient wait times is uniquely challenging when it comes to MR imaging. A 2017 study published in the American Journal of Roentgenology found that two avoidable process breakdowns accounted for as much as 30% of unnecessary wait time
at Beth Israel Deaconess Medical Center.
Outpatient wait time at Lahey Hospital had been, on average, 54 minutes, measured from the first arrival of the patient to administering the scheduled MR scan. The researchers at Dartmouth, after analyzing data in order to identify various common reasons for delay, used mathematical models and simulation algorithms for the purposes of reducing wait times and resulting costs incurred by the hospital. They found that by optimizing patient schedules with the use of these techniques outpatient MR wait times can be reduced, resulting in a 23% savings to the hospital without impeding patient access to care.
"The slot size should be adjusted if inconsistent with procedure durations," Dartmouth engineering professor Vikrant Vaze told HCB News. "The order of the exams is also worth investigating since some procedures take longer than others. For example, putting all the longer procedures at the start of the day would increase the overall waiting time for all patients throughout the day."