What is the relation between number of sessions worked and productivity of radiologists—a pilot study?

Abstract

Increasing workloads and the current austerity measures are putting UK radiology departments under considerable stress. We need to look at the most efficient ways to manage radiology departments in order to cope with increasing demand. Consequently, a system is needed that can compare productivity between radiologists with different jobs. We measured workload in a UK radiology department and compared the productivities of consultants working different numbers of sessions, which are called programmed activities (PAs), to identify the optimal job plan structure for reporting productivity. Reporting data was gathered from electronic records for 14 consultants working different numbers of PA during the period April 2010-March 2011. These were converted into relative value unit (RVU) scores using a modified RCSI RVU system. Crude and net workloads were calculated for each consultant by dividing their total RVU score by the number of PAs they were contracted for and how many they spent reporting. The consultants reported 118,001 imaging studies. There was statistically significant variation in productivity between consultants working different numbers of PAs on χ 2 analysis (p<0.05). Consultants working 12 PAs were more productive than consultants working 11 PAs, with net workloads of 7636 RVU/PA/year versus net 6146 RVU/PA/ year, p<0.05. Although UK consultants working 12 PAs per week are more productive than their colleagues, the reasons why are unclear. We have identified a method that can be developed further to identify efficient working practices in UK radiology departments. However, a UK-specific RVU system would make this productivity analysis more accurate.

Measuring radiologist workload: Progressing from RVUs to study ascribable times

“…The RANZCR RVU table first used in the Irish survey has also been adapted to the United Kingdom environment for measuring radiologist reporting workload. It was used in 2011 by Khan and Hedges to measure radiologist workload and productivity in the district general hospital setting . The UK RVU scoring table is quite short, with little allowance for different types of examinations within a modality.…”

“…The reading time does not include post-processing, and assumes study presented to the specialist in a readable format; (4) Undertaking exercise or pharmacologic stress testing accrues time by the logbook method separately from the reading time; (5) For cardiac MPS and gated studies, post-processing is done by technologist (orientation, slicing, lining up of two phases, etc. ); (6) 'scan for tumour' includes MIBI parathyroid studies; (7) For brain perfusion SPECT, the post-processing is done by technologist (orientation, slicing, lining up of two phases, etc. ); (8) CSF transit study also includes a CSF leak study; (9) Lymphoscintigraphy includes the doctor injecting the radiotracer, and not the technologist.…”

“…It was used in 2011 by Khan and Hedges to measure radiologist workload and productivity in the district general hospital setting. 7 The UK RVU scoring table is quite short, with little allowance for different types of examinations within a modality. It is also expressed in arbitrary RVU rather than in units of time.…”

An investigation to ascertain whether or not time pressure influences the accuracy of final year student radiographers in abnormality detection when interpreting conventional appendicular trauma radiographs: A pilot study

“…The results showed that the number of false positives decreased when under pressure. However, although nearly all radiologists coped with reporting in half of their original time, they reported that they would not be able to continue under such pressure 18 ; working under prolonged pressure can result in visual fatigue and cognitive overload 19 . Finally, a more recent study revealed that four out of the five radiologists that took part had more major misses when reporting at twice their original reporting speed 20 .…”

“…However, it is important to recognise that, despite the apparent trend between increased time pressure and interpretation accuracy, Edwards et al's study revealed radiologists could not work under such pressure for long periods of time 18 . Therefore, if such cognitive processes also relate to reporting practitioners, departments should ensure plenty of breaks in an attempt to avoid visual fatigue and cognitive overload 19 . It is also important to note that the slowest observer in the UTG had the lowest performance, which may reflect competence, and a single outlier could have skewed the results due to the very limited sample size.…”