Seltzer S E, Kelly P, Adams D F, Chiango B F, Viera M A, Fener E, Hooton S, Bannon-Rohrbach S, Healy C D, Doubilet P M, Holman B L
Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115, USA.
AJR Am J Roentgenol. 1997 Apr;168(4):889-93. doi: 10.2214/ajr.168.4.9124134.
The purpose of this study was to determine whether total quality management (TQM) techniques that had proved successful in a pilot study in one departmental section of a teaching hospital could be generalized for use by the entire radiology department.
Each departmental section developed interventions to improve its report turnaround time. These interventions were tailored to practice style and habits of each section. Commonly used interventions included electronic signature from the radiologist's home, a report-signing buddy system, elimination of a trainee signature requirement, accelerated transcription, structured reports, faster film delivery to reading desks, and training about the importance of radiology reports for clinical decision making. Specialized programs included computerized form-driven reporting and reports generated directly by computer voice recognition of radiologists' dictation. Our radiology information system provided data on each step in the reporting process.
The TQM approach produced significant improvements in departmental total report turnaround time (-55%; p = .001), transcription time (-80%; p = .003), and signature time (-68%; p = .0004). Each section achieved significant gains. The sonography section initiated a computerized, form-driven reporting system and outperformed the rest of the department.
TQM techniques can be expanded and generalized for department-wide projects in teaching hospitals.
本研究旨在确定在一家教学医院的一个科室试点研究中已证明成功的全面质量管理(TQM)技术是否可推广至整个放射科使用。
每个科室制定干预措施以缩短其报告周转时间。这些干预措施是根据每个科室的实践风格和习惯量身定制的。常用的干预措施包括放射科医生在家进行电子签名、报告签署伙伴系统、取消实习医生签名要求、加快转录、结构化报告、更快地将胶片送到阅片台以及开展关于放射学报告对临床决策重要性的培训。专门项目包括计算机化表单驱动报告以及由放射科医生听写的计算机语音识别直接生成报告。我们的放射学信息系统提供报告过程中每个步骤的数据。
TQM方法使科室总报告周转时间显著缩短(-55%;p = .001)、转录时间显著缩短(-80%;p = .003)以及签名时间显著缩短(-68%;p = .0004)。每个科室都取得了显著进展。超声科启动了计算机化表单驱动报告系统,其表现优于科室其他部门。
TQM技术可扩展并推广用于教学医院的全院范围项目。