A General Framework for Monitoring Image Acquisition Workflow in the Radiology Environment: Timeliness for Acute Stroke CT Imaging

Abstract

Many facets of an image acquisition workflow leave a digital footprint, making workflow analysis amenable to an informatics-based solution. This paper describes a detailed framework for analyzing workflow and uses acute stroke response timeliness in CT as a practical demonstration. We review methods for accessing the digital footprints resulting from common technologist/device interactions. This overview lays a foundation for obtaining data for workflow analysis. We demonstrate the method by analyzing CT imaging efficiency in the setting of acute stroke. We successfully used digital footprints of CT technologists to analyze their workflow. We presented an overview of other digital footprints including but not limited to contrast administration, patient positioning, billing, reformat creation, and scheduling. A framework for analyzing image acquisition workflow was presented. This framework is transferable to any modality, as the key steps of image acquisition, image reconstruction, image post processing, and image transfer to PACS are common to any imaging modality in diagnostic radiology.

Factors Contributing to Computed Tomography Trauma Scan Times at a Tertiary Center: Improving Emergency Department Trauma Imaging Workflow Through Targeted Interventions

“…16 Other studies have also demonstrated that standardizing and reducing variation in multistep work processes can lead to improved efficiency in patient care. [17][18][19] For example, Siegel et al 19 describe that at their institution, they estimate that automatic image display protocols have increased their radiologist's interpreting efficiency by 10% and saved them approximately 45 min/d. The clinical significance of the small decrease in ED LOS with this single intervention is unclear and may warrant further study, but if each trauma patient sees a decrease in LOS of 12 minutes and many trauma patients are seen in 24-hour period, these time savings become more substantial, particularly when combined with other incremental time saving interventions.…”

“…In studies where the Lean methodology is applied to radiology, “waiting” for people, information, or equipment is a critical signal of inefficient system processes 16 . Other studies have also demonstrated that standardizing and reducing variation in multistep work processes can lead to improved efficiency in patient care 17–19 . For example, Siegel et al 19 describe that at their institution, they estimate that automatic image display protocols have increased their radiologist's interpreting efficiency by 10% and saved them approximately 45 min/d.…”