Evaluating Turnaround Times for Diagnostic CT/MR Angiography Reports by an Interventional Radiology Division: A Single Institution’s Experience for Quality Improvement in the Current Era

Purpose: Prolonged turnaround time (TAT) for diagnostic exams is a ubiquitous challenge and often a significant cause of delay in patient care. At our institution, the interventional radiology (IR) section is responsible for reporting angiography exams. The objective of this study is to understand the causes of delays and to optimize efficiency.

Methods/Materials: Retrospective review of runoff and extremity CT/MR angiography exams performed over a 6-month period (Jan-June 2022), and review of the 6-month period (July-Dec 2022) after implementing an intervention. This yielded 335 & 427 exams in the pre- & post-groups, respectively. Data included total number of exams stratified by type of radiologist (IR/diagnostic), patient class (emergency/inpatient/outpatient), time/dates of each segment of the exam process, and corresponding time intervals such as exam-end to final report. Univariate analysis of the data was assessed with one-way ANOVA or unpaired t-tests. Our intervention consisted of a standardized daily & on-call workflow process with clearly defined roles & responsibilities for staff.

Results: Of 335 exams, 162 (45%) were finalized by IR. Mean TAT from end-exam to final was 8.1 days (± 8.1), with generally longer TAT for outpatient exams. Surprisingly, there was no significant difference between TATs for exams performed on weekdays & weekends. Also, there were no significant delays in TATs for protocoling, transportation, or image acquisition. Worklist filtering was also recognized as a major contributor to prolonged TATs, often more than 14 days. Post-intervention analysis revealed 427 exams, with 230 (54%) reports finalized by IR. Overall mean TATs for exam-end to final decreased to 2.63 days. There was a significant decrease in exam-end to final mean TAT for emergent exams of 3.5 days (±2.9) from 6.3 days pre-intervention, and similar trends with outpatient and inpatient exams.

Conclusions: There are numerous causes for reporting delays. This is a challenge for a clinical & procedural subspecialty, such as IR, given the limited time spent at a workstation. Our post-analysis demonstrates that these changes were effective in improving reporting efficiency, and thus, expedites & improves patient care.