1 Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical Center, 330 Brookline Ave, Boston, MA 02215.
AJR Am J Roentgenol. 2017 Oct;209(4):836-844. doi: 10.2214/AJR.16.17698. Epub 2017 Jul 20.
The objective of this study is to optimize MRI logistics through evaluation of MRI workflow and analysis of performance, efficiency, and patient throughput in a tertiary care academic center.
For 2 weeks, workflow data from two outpatient MRI scanners were prospectively collected and stratified by value added to the process (i.e., value-added time, business value-added time, or non-value-added time). Two separate time cycles were measured: the actual MRI process cycle as well as the complete length of patient stay in the department. In addition, the impact and frequency of delays across all observations were measured.
A total of 305 MRI examinations were evaluated, including body (34.1%), neurologic (28.9%), musculoskeletal (21.0%), and breast examinations (16.1%). The MRI process cycle lasted a mean of 50.97 ± 24.4 (SD) minutes per examination; the mean non-value-added time was 13.21 ± 18.77 minutes (25.87% of the total process cycle time). The mean length-of-stay cycle was 83.51 ± 33.63 minutes; the mean non-value-added time was 24.33 ± 24.84 minutes (29.14% of the total patient stay). The delay with the highest frequency (5.57%) was IV or port placement, which had a mean delay of 22.82 minutes. The delay with the greatest impact on time was MRI arthrography for which joint injection of contrast medium was necessary but was not accounted for in the schedule (mean delay, 42.2 minutes; frequency, 1.64%). Of 305 patients, 34 (11.15%) did not arrive at or before their scheduled time.
Non-value-added time represents approximately one-third of the total MRI process cycle and patient length of stay. Identifying specific delays may expedite the application of targeted improvement strategies, potentially increasing revenue, efficiency, and overall patient satisfaction.
本研究旨在通过评估 MRI 工作流程并分析三级保健学术中心的绩效、效率和患者吞吐量,优化 MRI 物流。
在 2 周内,前瞻性收集了两台门诊 MRI 扫描仪的工作流程数据,并按对流程的增值进行分层(即增值时间、业务增值时间或非增值时间)。测量了两个单独的时间周期:实际 MRI 流程周期以及患者在科室停留的总时长。此外,还测量了所有观察结果中的延迟影响和频率。
共评估了 305 例 MRI 检查,包括体部(34.1%)、神经(28.9%)、肌肉骨骼(21.0%)和乳腺检查(16.1%)。MRI 流程周期平均每例耗时 50.97 ± 24.4(SD)分钟;平均非增值时间为 13.21 ± 18.77 分钟(占总流程周期时间的 25.87%)。平均停留时间周期为 83.51 ± 33.63 分钟;平均非增值时间为 24.33 ± 24.84 分钟(占总患者停留时间的 29.14%)。频率最高(5.57%)的延迟是静脉或端口放置,平均延迟时间为 22.82 分钟。对时间影响最大的延迟是 MRI 关节造影术,需要关节内注射造影剂,但不在时间表内(平均延迟时间为 42.2 分钟;频率为 1.64%)。305 例患者中,有 34 例(11.15%)未按或未提前到达预约时间。
非增值时间占 MRI 总流程周期和患者停留时间的三分之一左右。确定具体的延迟可能会加速针对性改进策略的应用,从而提高收入、效率和整体患者满意度。