INTRODUCING a few key interventions has the potential to reduce delays for MRI exams performed on patients under sedation or general anaesthesia, according to recent research. The team behind the study, led by Aric Lee, National University Hospital, Kent Ridge, Singapore, found that certain uncomplicated initiatives, such as workflow standardisation and preadmission patient counselling cut delays for MRI exams by roughly one-third.
“Delays in MRIs, particularly those performed under sedation or general anaesthesia, can significantly impact resource utilization, timely diagnosis, and patient satisfaction,” the authors commented. As a result, Lee and colleagues aimed to reduce this delay amongst patients in the National University Hospital, where over 32,000 MRI exams are performed annually, over a 6 month period.
Over four cycles, several stages in the imaging process were altered by the multidisciplinary group. Interventions included standardising workflow, for example when booking the exam admissions; preadmission patient counselling consisting of a single-page checklist; clarifying scan times in order to ensure patient arrives at the correct time; and written consent for patient transfers from hospital rooms to the MRI suite. In total, the team assessed 627 MRI exams performed on patients under sedation or general anaesthesia between January 2022 and June 2023. Of these, 88.7% were conducted under sedation, 3.5% under monitored anaesthesia, and 7.8% under general anaesthesia; 443 were done before the interventions were implemented and 184 after the interventions were put into place. Preintervention, 71.6% of the scans were delayed more than 15 minutes and 28.2% by more than 60 minutes, with a median delay of 30 minutes.
The team found that though initial intervention implementation did not lead to decrease in delay times, there was significant decrease after implementing the second, third, and fourth interventions. Overall, the interventions resulted in a 34.7%-point reduction in scans delayed over 15 minutes, a 17.5%-point reduction in scans delayed by 60 or more minutes, and a reduced median delay time by 15 minutes.
Lee and team concluded that though “unavoidable reasons for delays, such as patient factors (for example, delirious or uncooperative patients, scanners accommodating emergent MRIs) [may] persist,” their research has shown achievable and effective ways to reduce delays. They added, “further work could also explore the adaptability of our quality improvement interventions across different imaging modalities or in diverse healthcare settings, such as regional hospitals within our network, to further enhance healthcare delivery.”
Victoria Antoniou, EMJ
Reference
Lee A et al. Reducing delays in MRIs under sedation and general anesthesia using quality improvement tools. J Am Coll Radiol. 2024;DOI:10.1016/j.jacr.2024.05.012.
