Fine-tuning workflow reduces breast imaging wait times

Flexible scheduling, prompt communication, and adequate staffing can help reduce critical wait time separating an abnormal breast mammogram and a final diagnosis. Decreased patient anxiety and more efficient operation result, according to a study presented at the 2004 RSNA meeting.

Project manager Prerna Singh Kahlon and colleagues at a large healthcare system in Massachusetts documented existing practices at six breast imaging centers from February to April 2004. They measured the amount of time it took to complete each step in the breast imaging and cancer diagnosis process: screening mammogram, diagnostic mammogram, core biopsy, biopsy results, and communication of biopsy results to the patient.

Throughout the breast imaging centers, critical wait time - defined as the time between an abnormal mammogram and final tissue diagnosis - varied from four to 24 days, with an average of 12.5 days.

The wait time range for each step broke down as follows:

• 0 to 13 days: time between screening and diagnostic mammogram

• 1.5 to 13 days: access to biopsy appointment

• 1 to 3 days: pathology turnaround

• 0.5 to 1.5 days: biopsy results communicated to patients

Different factors affected different hospitals.

"Scheduling, radiologist/technologist staffing, and communication of biopsy results by a radiologist or primary-care physician were the most common factors causing the longest delays," Kahlon said.

The process could be streamlined in several ways, including tailoring the schedule to avoid delays in obtaining a study, she said. Prompt biopsy specimen delivery would also shave time off the waiting period. Expediting film transport, providing prompt patient follow-up on biopsy reports, and allowing for scheduling flexibility are additional steps that departments can make to reduce the wait time.

"Providing high-quality patient care in a timely manner is key. The anticipated overall result of reducing critical wait time is a decrease in patient anxiety and an increase in patient satisfaction," Kahlon said.

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