Optimizing MRI Logistics: Focused Process Improvements Can Increase Throughput in an Academic Radiology Department

O'Brien, Jeremy J; Stormann, Jeremy; Roche, Kelli; Cabral-Goncalves, Ines; Monks, Annamarie; Hallett, Donna; Mortelé, Koenraad J.

doi:10.2214/ajr.16.16680

Cited by 25 publications

(15 citation statements)

References 17 publications

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“…In order to optimize the utilization of MRI in the most cost‐efficient manner, most radiology practices attempt to optimize exam protocols and MRI scheduling to minimize wasted time and resources . Typically, these efforts focus on limiting the number of acquired sequences, thereby limiting overall exam time . However, process optimization emphasizes minimizing both waste and variation as key steps in process improvement .…”

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confidence: 99%

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Factors predicting the time‐length variability of identically protocoled MRI exams

Avey

Belden

Zea

et al. 2019

Magnetic Resonance Imaging

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Background Clinical variability in MRI exam durations can impede efficient MRI utilization. There is a paucity of data regarding the degree of variability of identically protocoled MRI studies and when nontechnological factors contribute to time‐length variations in MRI exams. Purpose To measure the magnitude of variation in MRI exam duration for identically protocoled MRI exams and to identify potential contributors to variations in MRI exam times. Study Type Retrospective. Subjects 2705 identically protocoled MRI examinations of the cervical spine without contrast, comprehensive stroke exams, and comprehensive brain examinations performed on adult patients from June 30, 2016 through June 30, 2017. Assessment MRI exam duration was obtained directly from the image data. Potential predictors for exam length variability were evaluated including patient age, patient gender, performing technologist, patient status (inpatient/outpatient/emergency department), MRI field strength, use of sedation, day of week, and the time of day. Statistical Tests Linear regression analysis was performed for each individual variable after correcting for the MRI exam type. A multivariate mixed model was generated to assess for independent associations between the predictors and exam duration. Results There was substantial variability in the duration of the selected clinical MRI exams, with standard deviations (SDs) ranging between 19% and 29% of the mean exam length for each individual type of exam. The performing technologist was the most significant identified factor contributing to this variation in exam length; SD = 2.645 (P < 0.001). Compared with outpatient exams, inpatient exams required 4.18 minutes longer to complete (P < 0.001), and emergency department studies 1.86 minutes longer (P = 0.005). Male gender was associated with an additional 1.36 minutes of exam time (P < 0.001). Data Conclusion Nontechnical factors are associated with substantial variation in MRI exam times. These variations can be predicted based on relatively simple clinical and demographic factors, with implications for MRI exam scheduling, protocol design, staff training, and workflow design. Level of Evidence: 4 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2019.

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“…3 Typically, these efforts focus on limiting the number of acquired sequences, thereby limiting overall exam time. 4 However, process optimization emphasizes minimizing both waste and variation as key steps in process improvement. 5 The impact of exam length variability on scanner utilization, however, is often overlooked in this process.…”

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Factors predicting the time‐length variability of identically protocoled MRI exams

Avey

Belden

Zea

et al. 2019

Magnetic Resonance Imaging

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“…Our study demonstrated ABMR to have a 13% faster overall patient flow rate compared to FPMR. This gain in operational efficiency translates to increased capacity, improved patient access, reduced unit cost, and increased potential for revenue 12,17 growth. ABMR demonstrated a 39% reduction in magnet time compared to FPMR which is postulated to result in better patient care through improved compliance and less image motion artifact especially 10 for patients who suffer from claustrophobia.…”

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Patient Throughput Times for Supplemental Breast Cancer Screening Exams

Plaza¹,

Cole

Sanchez-Gonzalez

et al. 2021

Arch Breast Cancer

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Background: To optimize screening abbreviated breast MRI (ABMR) operations, patient throughput times of ABMR were compared to breast ultrasound (US) and full protocol breast MRI (FPMR).Methods: Patient throughput times (mean ± standard error) and its subcomponents were analyzed for 95 ABMRs, 90 breast US exams, and 50 FPMRs. Total patient throughput was measured from registration time to the time of the last acquired image. Actual exam time was time difference between the first and last acquired images and pre-examination time was the calculated difference between throughput and actual exam times. Results: ABMR total patient throughput time was shorter than FPMR (55.7 ± 1.7 vs. 63.1 ± 2.0 min; difference, 7.4 min, 13%; p<0.001), but longer than breast US (39.1 ± 1.3 min; difference, 16.6 min, 30%; p<0.001). ABMR had shorter actual scan times than FPMR (13.4 ± 0.14 vs. 18.6 ± 0.25 min; p<0.001), but longer than US (9.6 ± 0.46 minutes; p<0.001). There was no difference in the pre-examination times between ABMR and FPMR (42.3 ± 1.7 vs. 44.6 ± 1.9 min; p = 0.357); pre-examination times were longer for both MR exam types compared to US (29.5 ± 1.3 minutes; p<0.001). Conclusion: ABMR patient throughput times are faster than FPMR, but these gains are limited as they have no impact on pre-examination activities which comprise the lengthiest components of the patient flow process. US patient flow currently remains faster than ABMR; however, comparable ABMR times could be achieved by further omitting certain sequences and optimizing pre-examination processes.

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“…The table time for an MRI examination can be divided into three intervals with different value weighting: (a) value-added time (activities that directly benefit patients, primarily the actual image acquisition time), (b) business value-added time (necessary activities that consume time but do not directly influence patient care, such as preparing or cleaning the room), and (c) nonvalue-added time (time lost without activity, such as when the imaging equipment is idle) (6). Investigators have demonstrated that identifying possible inefficiencies and implementing change…”

Section: Optimizing Mri Logisticsmentioning

confidence: 99%

Abbreviated MRI Protocols for the Abdomen

et al. 2019

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Technical advances in MRI have improved image quality and have led to expanding clinical indications for its use. However, long examination and interpretation times, as well as higher costs, still represent barriers to use of MRI. Abbreviated MRI protocols have emerged as an alternative to standard MRI protocols. These abbreviated MRI protocols seek to reduce longer MRI protocols by eliminating unnecessary or redundant sequences that negatively affect cost, MRI table time, patient comfort, image quality, and image interpretation time. However, the diagnostic information is generally not compromised. Abbreviated MRI protocols have already been used successfully for hepatocellular carcinoma screening, for prostate cancer detection, and for screening for nonalcoholic fatty liver disease as well as monitoring patients with this disease. It has been reported that image acquisition time and costs can be considerably reduced with abbreviated MRI protocols, compared with standard MRI protocols, while maintaining a similar sensitivity and accuracy. Nevertheless, multiple applications still need to be explored in the abdomen and pelvis (eg, surveillance of metastases to the liver; follow-up of cystic pancreatic lesions, adrenal incidentalomas, and small renal masses; evaluation of ovarian cysts in postmenopausal women; staging of cervical and uterine corpus neoplasms; evaluation of müllerian duct anomalies). This article describes some successful applications of abbreviated MRI protocols, demonstrates how they can help in improving the MRI workflow, and explores potential future directions. ©

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Optimizing MRI Logistics: Focused Process Improvements Can Increase Throughput in an Academic Radiology Department

Abstract: Focused process improvements in selecting MRI protocols and scheduling examinations significantly increased throughput in the MRI division, thereby increasing capacity and revenue. Shorter scan and department times may also improve patient experience.

Cited by 25 publications

References 17 publications

Factors predicting the time‐length variability of identically protocoled MRI exams

Factors predicting the time‐length variability of identically protocoled MRI exams

Patient Throughput Times for Supplemental Breast Cancer Screening Exams

Abbreviated MRI Protocols for the Abdomen

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