Brigham and Women's Hospital, Department of Radiology, 75 Francis St, Boston, MA 02115; Harvard Medical School, Boston, Massachusetts.
Brigham and Women's Hospital, Department of Radiology, 75 Francis St, Boston, MA 02115; Harvard Medical School, Boston, Massachusetts.
Acad Radiol. 2021 Jan;28(1):1-7. doi: 10.1016/j.acra.2020.09.008. Epub 2020 Oct 2.
Quantify changes in total and by-subspecialty radiology workload due to deferring nonurgent services during the initial COVID-19 pandemic, and describe operational strategies implemented due to shifts in priority.
This retrospective, Institutional Review Board-exempt, study was performed between February 3, 2020 and April 19, 2020 at a large academic medical center. During March 9-15 (intervention period), nonurgent outpatient service deferments began. Five-week periods pre- (baseline) and postintervention (COVID) were defined. Primary outcomes were radiology volume (reports per day) overall and in 11 subspecialty divisions. Linear regression assessed relationship between baseline vs. COVID volumes stratified by division. Secondary outcomes included changes in relative value units (RVUs), inpatient and outpatient volumes.
There were 62,791 baseline reports vs. 23,369 during COVID; a 60% overall precipitous volume decrease (p < 0.001). Mean volume decrease pre- and during-COVID was significant (p < 0.001) amongst all individual divisions. Mean volume decrease differed amongst divisions: Interventional Radiology experienced least disruption (29% volume decrease), 7 divisions experienced 40%-60% decreases, and Musculoskeletal, Breast, and Cardiovascular imaging experienced >75% volume decrease. Total RVUs decreased 60% (71,186 baseline; 28,476 COVID). Both outpatient and inpatient report volumes decreased; 72% (41,115 baseline; 11,326 COVID) and 43% (12,626 baseline vs. 6,845 COVID), respectively. In labor pool tracking data, 21.8% (162/744) total radiology employees were reassigned to other hospital duties during the intervention period.
Precipitous radiology workload reductions impacted subspecialty divisions with marked variation. Data-driven operational decisions during COVID-19 assisted workflow and staffing assignment changes. Ongoing adjustments will be needed as healthcare systems transition operations to a "new normal."
量化因在 COVID-19 大流行初期推迟非紧急服务而导致的总放射学工作量和各亚专业工作量的变化，并描述因优先级变化而实施的运营策略。
这项回顾性的、机构审查委员会豁免的研究于 2020 年 2 月 3 日至 2020 年 4 月 19 日在一家大型学术医疗中心进行。在 3 月 9 日至 15 日（干预期间），开始推迟非紧急门诊服务。定义了干预前（基线）和干预后（COVID）的五周时间段。主要结果是放射学工作量（每天的报告数），总体上和 11 个亚专业领域。线性回归评估了按科室分层的基线与 COVID 期间体积之间的关系。次要结果包括相对价值单位（RVU）、住院和门诊量的变化。
基线时有 62791 份报告，COVID 时有 23369 份报告；总工作量急剧下降 60%（p<0.001）。在 COVID 之前和期间，所有个体科室的平均体积减少都有显著差异（p<0.001）。各科室平均体积减少差异较大：介入放射科受干扰最小（体积减少 29%），7 个科室减少 40%-60%，肌肉骨骼、乳房和心血管成像科室减少>75%。总 RVU 减少 60%（基线时 71186 个，COVID 时 28476 个）。门诊和住院报告量均减少；分别为 72%（基线时 41115 个，COVID 时 11326 个）和 43%（基线时 12626 个，COVID 时 6845 个）。在劳动力池跟踪数据中，在干预期间，21.8%（162/744）的放射科员工被重新分配到其他医院职责。
急剧减少的放射学工作量对各亚专业科室产生了显著影响。在 COVID-19 期间，数据驱动的运营决策有助于工作流程和人员配置的变化。随着医疗系统向“新常态”过渡，还需要进行持续调整。
