Report Turnaround Time of Different Imaging Modalities at Kenyatta National Hospital

Abstract

Background Diagnostic radiology plays a key role in the evaluation of patients seeking medical care as evidenced by the increasing demand of radiology services over the last few years. Referring physicians and patients are increasingly demanding expedited final reports to aid in clinical decision making and fast track patient care in both the inpatient and outpatient settings. Delays in reporting of results can lead to dissatisfaction among clinicians and their patients. The ultimate product of a radiology department is the final radiology report. Report turnaround time (RTAT) is a measure of the efficiency of a radiology department. Hospitals aim to achieve faster RTAT as it increases productivity of a radiology department and contributes to cost effectiveness of the hospital. Assessing turnaround times can help analyze workflow in the radiology department. Objective To determine the report turnaround time of different imaging modalities at Kenyatta National Hospital (KNH) and to highlight any gaps. Materials and methods A prospective cross-sectional study was carried out at KNH between 1st September and 30th November 2021. Consecutive sampling was done until the sample size was achieved. Every 3rd entry was recorded. The radiology reports generated were interrogated to measure the time taken from image acquisition to signing off of reports over the 3-month period. The modalities studied were plain radiography, PACS CT, non PACS CT scan and MRI. Each imaging study done was given a unique number and recorded for analysis. The date, time taken, requesting department and reporting time was recorded. Based on the data collected, the report turnaround time was calculated and data analyzed using SPSS package. The results were presented in tabular and graphical format. Results A total of 748 examinations comprising of 256 CT scans, 196 MRI scans and 333 plain radiographs were reviewed. Of the 256 CT scans 130 were done on the PACS system.The median time taken from image acquisition to generation of reports was lowest with the PACS CT at 8.8 hours, and highest with the non PACS CT which was at 115.6 hours(4.8 days). MRI studies had a RTAT of 71.5 hours (3 days). Plain radiographs had a RTAT of 24.9 hours (1 day). Emergency CT on PACS CT had RTAT of 6.1 hours while that on non PACS CT was 21 hours. xi The median time taken from image acquisition to generation of reports for the inpatients was 28.6 hours, and that for the outpatients was 24.9 hours. Time from report completion to collection was shortest on PACS CT, collected in less than 1 day. MRI, Plain radiographs reports were collected within 1 day after report completion. Conclusion Findings from this study show that the turnaround time for emergencies on PACS CT was 6.1 hours, which was longer than the 1 hour expected in an ideal set-up. Reports from the non-PACS CT took 115 hrs (4.8 days). These were mainly non-emergency cases. MRI studies had a RTAT of 71.5 hours (3 days) while the plain radiographs took 24.9 hours (1 day). For the emergency cases, the reports were collected within the day. The rest of the reports were collected within 24 hours. The RTAT for CT reports from the PACS system was 13 times faster than those from the non-PACS system. PACS can lead to increased productivity by improving efficiency at many levels.