Mackinnon A D, Billington R A, Adam E J, Dundas D D, Patel U
Department of Radiology, St Georges Hospital NHS Trust, London, UK.
Clin Radiol. 2008 Jul;63(7):796-804. doi: 10.1016/j.crad.2007.12.015. Epub 2008 Mar 25.
To evaluate the impact of picture archiving and communications systems (PACS) on reporting times and productivity in a large teaching hospital.
Reporting time, defined as the time taken from patient registration to report availability, and productivity, defined as the number of reports issued per whole time equivalent (WTE) radiologist per month, were studied for 2 years pre- and 3 years post-PACS installation. Mean reporting time was calculated for plain radiographs and specialist radiology techniques [computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine]. Productivity, total department workload, and unreported film rates were also assessed. Pre- and post-PACS findings were compared.
Between 2002-2006 the number of radiological patient episodes increased by 30% from 11,531/month to 15,057/month. This was accompanied by a smaller increase in WTE reporting radiologists, from 32 to 37 (15%). Mean reporting times have improved substantially post-PACS, plain radiograph reporting time decreased by 26% (from 6.8 to 5 days; p=0.002) and specialty modalities by 24% (4.1 to 3.1 days; p<0.001). Radiologist productivity has increased by 18% (337 films to 407 films/WTE radiologist/month). Unreported films have decreased from 5 to 4% for plain radiographs and are steady for specialty modalities (< 1%). In most areas improvements have been sustained over a 3-year period.
Since the introduction of PACS, reporting times have decreased by 25% and the productivity improved by 18%. Sustained improvements are felt to reflect the efficiencies and cultural change that accompanied the introduction of PACS and digital dictation.
评估图像存档与通信系统(PACS)对一家大型教学医院报告时间和工作效率的影响。
对PACS安装前2年和安装后3年的报告时间(定义为从患者登记到报告可获取的时间)和工作效率(定义为每位全职等效(WTE)放射科医生每月出具的报告数量)进行研究。计算了普通X光片和专科放射技术[计算机断层扫描(CT)、磁共振成像(MRI)、超声和核医学]的平均报告时间。还评估了工作效率、科室总工作量和未报告胶片率。比较了PACS安装前后的结果。
在2002年至2006年期间,放射科患者就诊次数从每月11,531次增加了30%,达到每月15,057次。与此同时,WTE报告放射科医生数量的增幅较小,从32人增加到37人(15%)。PACS安装后平均报告时间有了显著改善,普通X光片报告时间减少了26%(从6.8天降至5天;p = 0.002),专科检查减少了24%(从4.1天降至3.1天;p < 0.001)。放射科医生的工作效率提高了18%(从每位WTE放射科医生每月337张胶片增至407张)。普通X光片的未报告胶片率从5%降至4%,专科检查保持稳定(<1%)。在大多数领域,这些改善在3年期间得以持续。
自引入PACS以来,报告时间减少了25%,工作效率提高了18%。持续的改善被认为反映了引入PACS和数字口述带来的效率提升和文化变革。