Making Better Use of Turnaround Time Reports

By now most of us see TAT (turnaround time) reports. Most people understand why they matter.

So what do we realize we get out of “good” TAT? We get happy customers, faster charge submission and positive quality metrics. But TAT is something many folks dread. It can be inaccurate at times. It can become overly important, be confused with quality and lead to sloppiness. It is a tool, but only one as good as its operators.

What do I remind myself about when I see a TAT report?

TAT is the product of a number of people’s work. It’s not you versus them. This is an effort to provide good quality care, so it is a team effort, regardless of who writes the checks. Since it’s a team, work together, not against your system. Don’t be oppositional.

If you talk about it with a technical partner, like your hospital system, start with, “We’d like to make our turnaround as fast as possible and still good.” Ask them to dial in on the data and dissect it as finely as possible. That will make it as useful to you as possible. Get each time component broken out. Don’t accept things like “Patient arrival time to time of dictation” as a category without further analysis.

There is hidden time in the TAT. It is the nature of the system, reported by the technical-side most commonly, that it can overlook technical factors in the TAT. That puts the onus on the physician dictation and sign-off.

So don’t accept the TAT without reviewing it. Are there studies that are old included? What percentage of studies make it to you too slowly? Then think about why. Make sure those are identified in the report, and not counted in the standards.

The point here is not to point fingers. It is to get accurate data. For instance, we found that several studies a day were showing up from the prior day due to technical glitches in the PACS or because they were waiting for documents or comparison studies. Sure, we know that happens all the time. But if our performance standard is a percent of studies read in 24 hours, and we read about, say for example, 60 cross-sectional cases, it takes only three cases to reduce TAT by 5 percent. That makes most industry standards impossible to meet.

So make sure those are pulled out and put in their own pile. Then look at those cases individually with your technical side partners, for some period of time (a week, a month, etc.). See what is causing them to show up late and if there is a trend. Try to improve that process, too, while you work to improved dictation time and sign-off.

The radiologist impacts TAT most by improving sign-off. That is how some measure us and we all like to look good. Comparative measures can be motivation for us. I’m not afraid to have myself or my partners compared, preferably anonymously. It holds my feet to the fire to be rigorous about getting reports signed. It’s not worth risking a suit over though. Don’t be tempted to the dark side- having someone else sign for you. It is a legal morass to do so; avoid it at all costs.

You get lots of information and motivation from the TAT report, so use it.