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RING! Study measures impact of phone call interruptions on imaging workflow

by John W. Mitchell , Senior Correspondent
A group of U.K. radiologists, tired of phone calls interrupting their work, have brought the scientific method to bear on the problem.

In a paper recently published in Current Problems in Diagnostic Radiology, the researchers highlight several imaging workflow opportunities for improvement and suggest that electronic reporting systems are not being used as efficiently as they could be.

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“Calls to ask for imaging requests to be vetted comprised the highest number of calls overall and of calls deemed inappropriate,” Dr. Christopher Watura MBChB, BSc (Hons), radiology registrar at Imperial College Healthcare NHS Trust and lead author, told HCB News. “Radiology order communication systems with linked electronic patient records in modern departments mean that telephone interruptions to communicate requests and reports are necessary only in exceptional circumstances.”

The study also found that a radiology trainee receiving a call within an hour of completing an exam was linked to a 12 percent higher incidence of a discrepancy (possible error). However, more than half of the calls for vetting were found to be appropriate.

“This suggests that the full benefits of an electronic system are not yet being realized, and radiologists and referrers remain overreliant on, and accepting of, telephone interruptions for functional workflow,” said Watura.

The observational study over five regular workdays was conducted by radiologists across two large teaching hospital reporting rooms. A total of 288 calls were recorded, with 92 percent classified as interrupted reporting. Top reasons for calls included 48 percent to request an order be vetted, 17 percent asked for a study to be reported, 17 percent were classified as “other”, seven percent were to discuss a choice of study, and six percent requested a report review.

Watura stressed that a telephone call to expedite a report that has not been issued within a clinically specified time frame is “usually highly appropriate.” Such reporting delays increase patient anxiety and can negatively impact outcomes.

He sees an opportunity to reduce inefficiency by redesigning radiology workflow. This includes such changes as creating work times where interruptions are not permitted, assigning a radiologist to handle non-reporting tasks, such as screening calls, and better use of the electronic ordering and reporting system.

According to Watura, the U.K. has the third lowest number of radiologists per patient population in Europe, with a nine percent unfilled vacancy rate. And from 2013-2016, orders for CT and MRI scans increased by about a third.

“This critical resource shortage needs to be addressed in order to break the cycle of interruptions compounding inefficiency and delays in radiology reporting,” said Watura.

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