Minding patient queues improves radiology workflow

Radiology workflow can be optimized by customizing patient arrival distribution, according to a presentation at the 2005 Society for Computer Applications in Radiology meeting.

While patient arrival distribution is often overlooked in efficiency or workflow analysis, it has a major impact on departmental performance, specifically on patient wait times, exam backlog, and overall throughput, said Dr. Bruce I. Reiner of the VA Maryland Health Care System.

Patient wait times could potentially be reduced by electively scheduling nonemergent exams, performing inpatient exams during underutilized time periods, and staggering technologist staffing levels during lunch breaks and shift changes, he said.

Queuing management can provide important insight into decision making as it relates to allocation of resources in both personnel and technology, Reiner said.

Currently, technologist supply and demand are out of balance, with demand outweighing the availability of trained personnel.

"Although the transition from film-based to filmless operation has led to improved technologist productivity, little attention has been paid to the effect of patient arrival rates on departmental workflow and productivity," Reiner said.

In an optimized workflow, 100% of a technologist's time would be spent on exam performance. To accomplish this, a continuous, steady stream of patient arrivals is required, a scenario that doesn't mesh with the reality of intermittent patient arrival.

The overall range in patient arrivals and patient backlog can be reduced through the use of quantitative analysis and improved scheduling for both patients and staff, according to Reiner.

"By better understanding queuing analysis and its impact on service delivery, more cost-efficient decisions can be made about personnel, technology implementation, and room allocation," he said.

Understanding of queuing requires analysis of a number of parameters: scheduling and prioritization of procedures, patient arrival distribution, desired level of service, examination times, and staffing allocation.

Reviewing weekly or monthly statistics can shed light on departmental utilization trends, allowing for appropriate adjustments in departmental staffing during episodic peaks and valleys in patient arrivals.

"At the same time, proactive measures can be implemented in scheduling to further improve departmental efficiency by targeting relatively slow arrival distribution times for elective scheduling of nonemergent exams," Reiner said.