Abstract T P296: Diagnostic Testing in Acute Stroke Patients- The Weekend Waiting Game

Abstract

Background: Inpatient hospital stays contribute considerable costs to our total healthcare expenditures in the US. Increased lengths of stay can lead to increased costs. At the University of Kentucky, there appears to be delays in care in patients admitted over the weekend compared to those who are admitted during weekdays, due to availability of certain testing, such as MRI and transthoracic echocardiogram. This may lead to delays in delivering appropriate care, increase in length of stay, and possibly costs. Methods: We retrospectively reviewed charts for patients admitted to the University of Kentucky Chandler Medical Center between September to November 2012. Patients were divided into two groups based on the day of the week tests were ordered. Group 1 included patients on whom MRI or echocardiogram was ordered between Monday through Thursday. Group 2 included patients on whom tests were ordered Friday through Sunday. Results were compared using the two sample t-test. Results: A total of 275 MRIs were performed on stroke patients. For Group 1 (n=168) procedures, mean time to completion was 13.2 hours +/- SD 12.6. For Group 2 (n=97), the mean time to completion was 20.7 hours +/- SD 19.5 (p=.002). A total of 272 echocardiograms were performed. For group 1 (n=171), mean time to completion was 17.4 hours +/- SD 11.2. For Group 2 (n=97), the mean time to completion was 33.4 hours +/- SD 21.6, (p<.0001). Conclusion: There was a 57% increase in the time needed to complete MRI and 92% increase in the time needed to complete echocardiogram when it was ordered on the weekend. This represents a significant delay in care and may impact lengths of stay. The hiring of additional MRI and echocardiogram technicians could reduce delays in patient care and lengths of stay. This in turn may reduce costs for both patients and the system.