Abstract
BackgroundIncreasing demand for magnetic resonance imaging (MRI) has contributed to extended patient waiting times worldwide. This is particularly true in resource-limited environments, prompting this institutional workflow analysis.ObjectiveTo determine the ‘pre-’ and ‘post-scan’ times for normal-hour MRI studies conducted at a tertiary-level, public-sector South African hospital and to assess any association with demographic details, patient characteristics, anatomical site and scan parameters. A secondary objective was determination of the average daily MR ‘down’ time.MethodsA prospective descriptive study stratifying MRI workflow into ‘pre-scan’, ‘scan’, ‘post-scan’ and ‘down’ times. During ‘pre-‘ and ‘post-scan’ times patients occupied the scanner whilst staff performed tasks indirectly contributing to image acquisition. During ‘down’ time no patient occupied the MRI room. ‘Pre-’ and ‘post-scan’ times were compared with demographic details, patient characteristics, anatomical site and study parameters, utilising correlation analysis or analysis of variance (ANOVA).ResultsA total of 223 patients (n = 223) underwent 286 investigations in the 23-day review period. Seventy per cent of routine working time was utilised in image acquisition. The ‘pre-’ and ‘post-scan’ times together accounted for 19% and ‘down’ time for 11% of working time. Prolonged ‘pre-’ and ‘post-scan’ times were independently associated with age less than 12 years, anaesthesia, sedation and immobility (p < 0.01 in all cases). The longest median combined ‘pre-’ and ‘post-scan’ time by anatomical site (cholangiopancreatography, 21:46 min) was more than six times the shortest (pituitary fossa, 3:11 min).ConclusionA critical analysis of magnetic resonance ‘pre-’ and ‘post-scan’ times can provide valuable insights into opportunities for enhanced service efficiency.
Highlights
There is an increasing global demand for radiological services, including magnetic resonance imaging (MRI).[1,2,3,4,5] Continual technological advances, ongoing evolution of imaging sequences and the absence of ionising radiation contribute to ever-increasing clinical applications for MRI
Intravenous contrast was administered to almost half (n = 93, 42%), and approximately one-quarter (n = 52, 23%) required either anaesthesia (n = 20; 9%) or sedation (n = 32, 14%)
More than one-fifth (n = 48, 22%) had limited mobility; forty-eight patients were less than 12 years of age (22%)
Summary
There is an increasing global demand for radiological services, including magnetic resonance imaging (MRI).[1,2,3,4,5] Continual technological advances, ongoing evolution of imaging sequences and the absence of ionising radiation contribute to ever-increasing clinical applications for MRI. Burgeoning clinical demand in the face of finite equipment resources has resulted in extended MRI waiting times worldwide. This is especially true in the public healthcare services of low- and middle-income countries (LMICs),[5,6] including South Africa (SA). Increasing demand for magnetic resonance imaging (MRI) has contributed to extended patient waiting times worldwide. This is true in resource-limited environments, prompting this institutional workflow analysis
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