Effects of Interpersonal Skills Training on MRI Operations in a Saturated Market: A Randomized Trial

Abstract

Purpose Assess effects of team training on operational efficiency during outpatient MRI. Materials and Methods In this IRB-approved HIPAA-compliant study, 6 MRI outpatient sites of a Midwestern hospital system were randomized to serve as controls or have their teams trained in advanced communication skills. The 4th quarter fiscal year 2015 (Q4FY15) was the trial baseline. The trial ended Q3FY16. Equipment utilization (completed scans/available slots), hourly scan rates (total orders completed per machine per hour of operation), and no-show rates stratified by time were analyzed using the Cochran-Mantel-Haenszel method, with individual comparisons performed with Bonferroni correction. Results The study encompassed 27,425 MRI examinations. Overall volume peaked at baseline and then declined over the next quarters. Compared to baseline, untrained sites experienced significant drops in equipment utilization (p<0.01 [Q1FY16]; p<0.0001 [Q2 FY16, Q3FY16]), decreasing from 77% to 65% over the study period, corresponding to a decrease from 1.15 to 0.97 in hourly scan rates. For trained sites, these metrics showed no significant change, with maintenance of hourly scan rates of 1.23 and 1.27 and equipment utilization rates of 83% and 85% between baseline and Q3FY16. No-show rates remained stable at trained sites but increased at untrained sites in the last two quarters (p<0.05). Nationally benchmarked patient satisfaction percentile ranking gradually increased at trained sites from 56th at baseline to 70th and successively decreased at untrained sites from 66th to 44th. Conclusion MRI outpatient facilities trained in advanced communication techniques may have more favorable operational efficiency than untrained sites in a saturated market.

Economics of MRI Operations After Implementation of Interpersonal Skills Training

“…These were driven mainly by a decrease in no-shows, with an increased number of patients examined and an increase in the cost of equipment operation in this model. A decrease in no-shows after training has been shown in other trials [8, 11] and is intriguing in its context. Most importantly however, there were increases in revenue and profit.…”

“…In a prior randomized controlled trial, implementing team training improved patient satisfaction and reduced the incidence of delayed or cancelled MRI exams. [8] These studies were based on the experience of MRI outpatient sites at an urban Midwestern hospital system. The effects of team training we reported in that study were larger—in an absolute sense—than the effects we report in this study, and cost savings would likely be greater there.…”

“…The original protocol aimed to reproduce a randomized trial design that had been successfully used in a Midwestern urban hospital center to assess the effect of interpersonal skill training on MRI outpatient operational efficiency. [8] We planned to randomize 6 non-overlapping MRI teams to receive training or serve as controls. Two teams worked in two freestanding outpatient sites; two teams worked at two separate MRI sites on the hospital campus during morning shifts, and two other teams worked at the same campus MRI sites during evening shifts.…”

“…The effects that (1) patient factors interfering with scan efficiency and (2) measures of how to address them have on overall costs and revenue are largely unknown. Team training in interpersonal skills for staff members of MRI centers has been shown to improve patient satisfaction and operational efficiency, including measures of scan rates, no-show rates, and study incompletion rates,[8–11] thus affording an opportunity to assess such effects.…”

Paradigms in Integrative Medicine and the Place of Clinical Hypnosis

“…Hypnosis facilitates pain management for a wide variety of pain types, including acute pain, chronic pain, and pain accompanying medical procedures [15,24,25]. Hypnosis and hypnotic language can also be utilized by hospital and clinic personnel, with significant improvements in patient satisfaction [26,27].…”