Same-day MRI scans boost radiology productivity

 

 

 

 

Researchers at University Hospital Giessen and Marburg in Germany took productivity and quality improvement methodologies such as Lean Six Sigma that have succeeded in manufacturing and other service industries, and applied them to radiology departments. The changes increased the percentage of patients who received MRI scans within 24 hours from 53% to more than 90%, and monthly patient throughput rose by 38%.

As a result, revenue and savings increased by approximately 247,000 euros ($345,800 U.S.) in the first year of implementation (JACR, September 2011, Vol. 8:9, pp. 649-656).

Lead study author Li Zhang, PhD, in the department of diagnostic radiology, worked with colleagues to collect data from the 1,200-bed academic hospital, which has two 1.5-tesla MRI scanners (Magnetom Sonata and Magnetom Espree, Siemens Healthcare). The facility operated its two MRI systems for 19 hours, Monday through Thursday, and for 12 hours on Friday. There were no on-call hours and no exams on holidays, and no changes were made in the number of hours the department was open during the study period.

Based on the responses, the group identified 14 areas where processes could be improved to heighten productivity, reduce wasted time, and meet physician and patient needs. For example, the facility prompted radiologists to improve their feedback to technologists when information was missing or insufficient. It also worked to upgrade skills for technologists who were not completely familiar with MRI procedures.

Additional checks were instituted to ensure the following:

  • MRI scans were not inadvertently repeated
  • Referring physicians specified the correct part of the body for MRI scanning
  • Patients’ whereabouts were known and confirmed prior to an exam
  • MRI scan protocols were specified ahead of time and not determined at the scan by the technologist

The facility also increased its technologist staffing levels by at least one full-time position to 3.5 and to four full-time positions when volume warranted. The additional staffing “made a contribution of about 10% to the total increase in throughputs,” Zhang and colleagues concluded. With 2.5 technologists, throughput was 20 patients (± 4) on an average day, compared with 23 patients (± 5) on an average day after the changes.

Patient throughput

At the beginning of the study period, an estimated 53% of patients had access to an MRI scan within 24 hours, with the facility averaging a total of 17 scans on a daily basis with the two machines. That increased to 90% following the changes.

Overall, monthly patient throughput prior to the changes was 349 patients (± 25), compared with 432 patients (± 43) during the transition phase. With new policies in place, monthly throughput advanced to 482 patients (­± 38).

As for the financial benefit, the authors estimated that the total cost to implement the new processes was 88,000 euros ($123,200 U.S.). With the new procedures in place, the average number of daily MRI scans increased from 17 under the old procedures to an average of 22.5 MRI exams per day.

Based on a 268-day time period, the number of MRI scans increased from 4,650 prior to the changes to 6,049 under the new processes, an increase of 1,399 exams. When the financial impact is calculated for insured patients and the reduction of MRI scan delays for inpatients, revenue and savings gains total 335,000 euros ($469,000 U.S.).

Before changes After changes
Average MRI exams per day 17.4 22.5
MRI exams over 268 days 4,650 6,049
Increase in total MRI exams 1,399
Revenue (normal insured patients) 109,000 euros
($152,600 U.S.)
Revenue (private insured patients) 57,000 euros
($79,800 U.S.)
Savings of delay cost (inpatients) 168,000 euros
($235,200 U.S.)
Total revenue and savings 335,000 euros
($469,000 U.S.)
Table courtesy of JACR.
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Public Workshop – Magnetic Resonance Imaging Safety FDA

The Food and Drug Administration (FDA) is announcing a public workshop entitled: “Magnetic Resonance Imaging (MRI) Safety Public Workshop.” The purpose of the public workshop is to discuss factors affecting the safe use of magnetic resonance imaging (MRI) and approaches to mitigate risks. The overall goal is to discuss strategies to minimize patient and staff risk in the MRI environment. The topics to be discussed are: general MRI safety, ferromagnetic detectors, scanning patients with medical implants, and the impact of innovation on MRI safety concerns. Additional background about Magnetic Resonance Imaging can be found at MRI (Magnetic Resonance Imaging).

The purpose of the workshop is to discuss factors affecting the safe use of magnetic resonance imaging (MRI) devices and approaches to mitigate risks.

 

Background

The number of MRI procedures performed each year continues to rise. At the same time, MRI technology, implanted medical devices and medical device accessories (non-implanted) are becoming more complex. There is increasing demand to scan patients with implanted or accessory medical devices, and the presence of these devices are becoming commonplace in the MRI suite during imaging procedures. While MRI procedures are relatively safe, there are hazards inherent to the MRI environment that must be considered to ensure the safety of patients, healthcare providers and others who enter the MRI suite. The Agency recognizes the need to work with stakeholders to identify hazard reduction strategies that minimize risk in the MRI environment.

Through this effort, FDA and stakeholder groups will take steps to promote the safe use of MRI by increasing awareness of safety issues that may occur in the MRI environment and by identifying regulatory, policy and system-oriented solutions to mitigate risk. FDA can advance these goals by collaborating with medical device and health care industries, and the healthcare provider and consumer communities.

 

Transcripts and Archived Webcast

Please be advised that as soon as a transcript is available, it will be accessible athttp://www.regulations.gov. It may be viewed at the Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD. A transcript will also be available in either hardcopy or on CD-ROM, after submission of a Freedom of Information request. Written requests are to be sent to Division of Freedom of Information (HFI-35), Office of Management Programs, Food and Drug Administration, 5600 Fishers Lane, rm. 6-30, Rockville, MD 20857. A link to the transcripts will also be available on this page approximately 45 days after the public workshop.

Archived webcasts are currently available:

Contacts for Additional Information

For information regarding the program, contact:

Carol Krueger
Office of the Center Director
Center for Devices and Radiological Health
Food and Drug Administration
10903 New Hampshire Avenue
Bldg 66, Room 5437 br /> Silver Spring, MD 20993
Phone: 301-796-3241
Email: Carol.Krueger@fda.hhs.gov

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