Redfern R O, Langlotz C P, Abbuhl S B, Polansky M, Horii S C, Kundel H L
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
J Digit Imaging. 2002 Sep;15(3):153-60. doi: 10.1007/s10278-002-0024-5. Epub 2002 Nov 6.
The purpose of this study was to evaluate the effect of a switch to a filmless image management system on the time required for technologists to produce radiographic images in the emergency department (ED) after controlling for exam difficulty and a variable workload. Time and motion data were collected on patients who had radiographic images taken while being treated in the emergency department over the 3 1/2-year period from April 1997 to November 2000. Event times and demographic data were obtained from the radiology information system, from the hospital information system, from emergency department records, or by observation by research coordinators. Multiple least squares regression analysis identified several independent predictors of the time required for technologists to produce radiographic images. These variables included the level of technologist experience, the number of trauma-alert patient arrivals, and whether a filmless image management system was used (all P <.05). Our regression model explained 22% of the variability in technologist time (R2 Adjusted, 0.22; F = 24.01; P <.0001). The regression model predicted a time saving of 2 to 3 minutes per patient in the elapsed time from notification of a needed examination until image availability because of the implementation of PACS, a delay of 4 to 6 minutes per patient who were imaged by technologists who spent less than 10% of their work assignments within the ED, and a delay of 18 to 27 minutes in radiology workflow because of the arrival of a trauma alert patient. A filmless system decreased the amount of time required to produce radiographs. The arrival of a trauma alert patient delayed radiology workflow in the ED. Inexperienced technologists require 4 to 6 minutes of additional time per patient to complete the same amount of work accomplished by an experienced technologist.
本研究的目的是在控制检查难度和可变工作量之后，评估切换到无胶片影像管理系统对急诊科（ED）技术人员生成放射影像所需时间的影响。在1997年4月至2000年11月的3年半时间里，收集了在急诊科接受治疗时拍摄了放射影像的患者的时间和动作数据。事件时间和人口统计学数据来自放射信息系统、医院信息系统、急诊科记录，或由研究协调员进行观察获取。多元最小二乘回归分析确定了技术人员生成放射影像所需时间的几个独立预测因素。这些变量包括技术人员的经验水平、创伤警报患者的到达数量，以及是否使用了无胶片影像管理系统（所有P <.05）。我们的回归模型解释了技术人员时间变异性的22%（调整后的R2为0.22；F = 24.01；P <.0001）。回归模型预测，由于实施了PACS，从通知需要检查到影像可用的 elapsed 时间每位患者可节省2至3分钟；对于在急诊科工作任务中花费不到10%时间的技术人员所成像的患者，每位患者会延迟4至6分钟；由于创伤警报患者的到来，放射科工作流程会延迟18至27分钟。无胶片系统减少了生成X光片所需的时间量。创伤警报患者的到来延迟了急诊科的放射科工作流程。经验不足的技术人员每位患者完成与经验丰富的技术人员相同工作量需要额外4至6分钟时间。
