REPORT TURNAROUND TIME (ReTAT) IN A NUCLEAR MEDICINE DEPARTMENT: ROOT CAUSE ANALYSIS AND ACTIONS PLANS FOR PROCEDURES REPORTED BEYOND BENCHMARK

Abstract

Abstract

Background: Report turn-around time (ReTAT) is an important indicator of quality healthcare. Availability of effective hardware and software technologies have shortened ReTAT from hours to minutes. Purpose of this audit in a nuclear medicine section was to explore the reasons for small percentage of procedures reported beyond the benchmark and to make strategies to avoid such delays.

Material and Method: This audit was conducted at Nuclear Medicine section of Aga Khan University Hospital Karachi, Pakistan and ReTAT data from 1.1.2017 till 30.11.2017 was collected. %ReTAT within and beyond institutional benchmark were analyzed. Root cause analyses (RCA) for delays were done and strategies to avoid such delays were made.

Results: During study period total 5905 procedures were performed (Outpatient clinic: 2811; Outside referral: 2828; In-patient: 262; Emergency Room: 04). Overall %ReTAT within benchmark was 97.15% (range: 95.15 – 100%) and for ER procedures it was 100%. ReTAT beyond benchmark was found in 168 (2.85%) procedures. Delay was considered justified for procedures with imaging protocols beyond 24 hour in 55/168 (33%). In 113/168 (67%) procedures, delays were considered unjustified caused by either prior registration or delayed submission of patients’ files to reporting suite. For justified delays and prior registration we have made a strategy to acknowledge these procedures in RIS. For delayed submission of patients’ folder to reporting suites, allocation of scans according to duty roster into the bin of reporting physician and system generated alerts to NM section head for un-reported procedures 8 hour after registration are planned. The impact of these strategies will be evaluated in a follow-up audit.

Conclusion: A timely available imaging report has a significant impact upon patient’s management. Our %ReTAT is well within institution’s bench mark (around 97% against >90% benchmark). By conducting this audit we performed root cause analyses for small percentage of procedures reported beyond ReTAT benchmark. We have made strategies for each explored cause and planned to perform a follow-up audit to measure the target outcomes.