UF Health Jacksonville neurology patients who require medical imaging are getting their scans much sooner, thanks in large part to an in-house, multiple department effort to reduce turnaround times. The change is resulting in more efficiency, increased throughput and improved patient satisfaction.
In 2012, neurology faculty noticed that up to half of all inpatient neurology MRIs were taking more than 24 hours to obtain. They began collecting data and investigating each delay.
“It was felt these delays could ultimately prolong diagnosis and treatment and potentially delay discharge to home or rehabilitation,” said Ryan Crooks, MD, an assistant professor of neurology at the University of Florida College of Medicine – Jacksonville. Crooks authored a study of the investigation and intervention with nurse practitioner Loretta Schnepel and Scott Silliman, MD, a professor of neurology at UF COMJ.
Common causes for delay included the availability of scanners, the lack of timely patient screening prior to an MRI and the inability for some patients to tolerate the scanning process. After those issues were identified, an interdisciplinary committee was formed that featured faculty and staff from neurology, radiology, nursing information technology and administration.
Crooks said another issue involved the acknowledgment of MRI orders after they were placed.
“When the order was initially placed, it would get missed and would remain in limbo until completed,” he said. “This was something that was consistently overlooked given the busy pace of an inpatient admission. A simple correction — installing a ‘pop up’ reminder in the system if this was missed — essentially remedied the problem.”
The heightened attention and changes resulted in significantly improved turnaround times of scans. For instance, from July to October 2012 — the first four months of data collection — 36 percent of MRI studies took more than 24 hours to complete from the time they were ordered. After this intervention, that rate dropped to 13 percent.
Overall, there was a 52 percent decrease in the number of scans that took more than a day to complete. Data for the study were collected through early 2016.
“Our ability to obtain diagnostic imaging for our neurology patients has improved. We often have the MRI completed within a day of a patient’s admission,” Crooks said. “The interventions remain in place, and we have noted very little issue with obtaining an MRI overnight. It is the exception rather than the norm.”
The study won “Most Outstanding Quality Improvement Poster Presentation” during UF COMJ’s 2016 Celebration of Education event in June and was presented that same month at the Association of American Medical Colleges’ Integrating Quality Meeting in Illinois.