Reducing Interruptions in the Reading Room: Standardized CT/MRI Contrast Orders

Abstract

THE PROBLEM One major source of interruptions in workflow that we identified in our academic practice was phone calls to the radiology reading room from technologists and nursing staff members requesting written prescription orders for oral and intravenous contrast and prescription of protocols to be entered into our computerized protocoling system. Technologists would routinely call for protocols and nurses would call for contrast media, with potentially a minimum of two phone calls per patient examination. Although prescribing imaging protocols and contrast orders are essential tasks for quality patient care, this pattern of workflow in our department was problematic, inevitability leading to delays and interruptions of patient care at multiple levels. For patients, wait times were potentially prolonged because orders were not in place in advance of patients’ arrival to the department. For technologists and nurses, the time spent trying to contact physicians negatively affected throughput and could potentially lead to errors due to interruptions in their workflow. For radiologists, interruptions in the reading room lead to prolonged turnaround times, foreshortened consultations with referring clinicians and readout sessions with trainees and potential errors in image interpretation or reports. Error rates in interpretations rendered by radiologists range from