Matthew H Lee1, Andrew J Schemmel1, B Dustin Pooler1, Taylor Hanley2, Tabassum A Kennedy1, Aaron S Field3, Douglas Wiegmann2, John-Paul J Yu4. 1. Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI. 2. Department of Industrial and Systems Engineering, College of Engineering, University of Wisconsin, Madison, WI. 3. Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Biomedical Engineering, College of Engineering, University of Wisconsin, Madison, WI. 4. Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Biomedical Engineering, College of Engineering, University of Wisconsin, Madison, WI; Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI. Electronic address: jpyu@uwhealth.org.
Abstract
PURPOSE: To assess the impact of separate non-image interpretive task and image-interpretive task workflows in an academic neuroradiology practice. MATERIALS AND METHODS: A prospective, randomized, observational investigation of a centralized academic neuroradiology reading room was performed. The primary reading room fellow was observed over a one-month period using a time-and-motion methodology, recording frequency and duration of tasks performed. Tasks were categorized into separate image interpretive and non-image interpretive workflows. Post-intervention observation of the primary fellow was repeated following the implementation of a consult assistant responsible for non-image interpretive tasks. Pre- and post-intervention data were compared. RESULTS: Following separation of image-interpretive and non-image interpretive workflows, time spent on image-interpretive tasks by the primary fellow increased from 53.8% to 73.2% while non-image interpretive tasks decreased from 20.4% to 4.4%. Mean time duration of image interpretation nearly doubled, from 05:44 to 11:01 (p = 0.002). Decreases in specific non-image interpretive tasks, including phone calls/paging (2.86/hr versus 0.80/hr), in-room consultations (1.36/hr versus 0.80/hr), and protocoling (0.99/hr versus 0.10/hr), were observed. The consult assistant experienced 29.4 task switching events per hour. Rates of specific non-image interpretive tasks for the CA were 6.41/hr for phone calls/paging, 3.60/hr for in-room consultations, and 3.83/hr for protocoling. CONCLUSION: Separating responsibilities into NIT and IIT workflows substantially increased image interpretation time and decreased TSEs for the primary fellow. Consolidation of NITs into a separate workflow may allow for more efficient task completion.
RCT Entities:
PURPOSE: To assess the impact of separate non-image interpretive task and image-interpretive task workflows in an academic neuroradiology practice. MATERIALS AND METHODS: A prospective, randomized, observational investigation of a centralized academic neuroradiology reading room was performed. The primary reading room fellow was observed over a one-month period using a time-and-motion methodology, recording frequency and duration of tasks performed. Tasks were categorized into separate image interpretive and non-image interpretive workflows. Post-intervention observation of the primary fellow was repeated following the implementation of a consult assistant responsible for non-image interpretive tasks. Pre- and post-intervention data were compared. RESULTS: Following separation of image-interpretive and non-image interpretive workflows, time spent on image-interpretive tasks by the primary fellow increased from 53.8% to 73.2% while non-image interpretive tasks decreased from 20.4% to 4.4%. Mean time duration of image interpretation nearly doubled, from 05:44 to 11:01 (p = 0.002). Decreases in specific non-image interpretive tasks, including phone calls/paging (2.86/hr versus 0.80/hr), in-room consultations (1.36/hr versus 0.80/hr), and protocoling (0.99/hr versus 0.10/hr), were observed. The consult assistant experienced 29.4 task switching events per hour. Rates of specific non-image interpretive tasks for the CA were 6.41/hr for phone calls/paging, 3.60/hr for in-room consultations, and 3.83/hr for protocoling. CONCLUSION: Separating responsibilities into NIT and IIT workflows substantially increased image interpretation time and decreased TSEs for the primary fellow. Consolidation of NITs into a separate workflow may allow for more efficient task completion.