SHM Converge Scientific Abstract ePoster Gallery-Improving the Mri Turnaround Time in an Academic Safety Net Hospital

Pdf Summary

This project aimed to improve MRI turnaround time (TAT) at an academic safety net hospital using Lean process improvement methods. The team identified multiple delays in the inpatient MRI workflow through process mapping, including paper-based device clearance forms, telephone-only communication between departments, unclear responsibility for ordering EP consults and chest X-rays, incomplete MRI screening forms, lack of triage/priority information, inappropriate MRI orders, no screening for anxiolytic needs or medical stability, transportation delays, overlapping inpatient and outpatient MRI schedules, poor coordination across steps, limited MRI capacity, and unclear discharge readiness information.<br /><br />To address these barriers, the hospital implemented several changes: EHR-based device clearance forms and communication, BPA prompts to trigger EP consults and chest X-rays when indicated, alerts to prevent incomplete screening forms, training RNs to screen for anxiolytic needs, standardized assessment and communication of medical stability, a 5-minute transport wait policy, separate operating hours for inpatient and outpatient MRI, creation of an MRI coordinator role, a mobile MRI unit, and discharge color-coding visible to the MRI team. Additional tools included CareSelect for better study ordering and CDSM alerts based on ACR guidelines.<br /><br />Results showed improvement after intervention. A total of 9,278 MRI studies were completed in the baseline period and 9,598 post-intervention. Average MRI TAT decreased from 1,933 to 1,793 minutes per study (p=0.0071). Time from order entry to exam start fell from 1,318 to 1,183 minutes (p=0.011), and exam duration decreased from 70.4 to 66.6 minutes (p=0.010). MRI volume also increased from 149.6 to 162.6 studies per week, though this was not statistically significant.<br /><br />Overall, the multidisciplinary Lean intervention significantly improved MRI efficiency, mainly by reducing the delay between order placement and exam initiation.

Asset Subtitle

Giuseppe Annunziata

Meta Tag

Author List Ankur Segon, Christopher Vineyard, Giuseppe Annunziata, Hannah R. Vanderlinden-Willis, Saket Kottewar

Category Research

Concept Magnetic Resonance Imaging

Concept Turnaround Time

Concept Lean Process Improvement

Concept Root Cause Analysis

Concept Order-to-Start Time

Distinguished Non-Finalist

Presenter Organization UT Health San Antonio - Lozano Long School of Medicine

Presenting Author Giuseppe Annunziata

Track Quality Improvement

Keywords

MRI turnaround time

Lean process improvement

inpatient MRI workflow

academic safety net hospital

process mapping

EHR-based clearance forms

MRI screening

transportation delays

MRI coordinator

CareSelect

Magnetic Resonance Imaging

Turnaround Time

Lean Process Improvement

Root Cause Analysis

Order-to-Start Time