92% of phone calls to radiology reporting rooms interrupt workflow

Phone calls directed to radiology reporting rooms interrupt clinicians’ work more than 90 percent of the time and could be decreasing reporting accuracy in a big way, a trio of British researchers said this month in Current Problems in Diagnostic Radiology.

Radiologists field hundreds of calls a week in the reporting room, corresponding author Christopher Watura, MBChB, and colleagues wrote. Of those calls, less than 10 percent are considered appropriate interruptions to radiologists’ workflow.

“It is part of everyday practice for healthcare professionals to interrupt one another to communicate urgent information,” Watura et al. wrote. “When an individual’s attention is diverted from [the] primary task, memory of the primary task begins to decay while processing the interrupting task. After returning to complete the remainder of the primary task, the likelihood of making an error is increased.”

Timely reporting is key to a successful practice, the authors wrote, especially in the case of Watura and co-authors’ work at London’s Imperial College Healthcare NHS Trust. In a country where more than 73 percent of NHS patients wait more than a month for radiology results, U.K. officials and physicians are looking to cut waiting times while retaining quality.

Watura’s team conducted a observational, five-day study to assess the reality of telephone interruptions in radiology reporting rooms, focusing on two large teaching hospitals in London. Participating radiologists were asked to record all of their calls between 9 a.m. and 5 p.m. during study days and rate the “appropriateness” of each interruption.

Of 288 recorded calls and 23 returned forms, the authors found that 92 percent of calls interrupted radiologists’ reporting tasks. While 58 percent of those calls were considered appropriate by the radiologist, the remainder of interruptions were inappropriate, consisting of requests to be vetted, inquiries about reporting studies or “other” situations. Other calls were wrong numbers, returning bleeps or discussing study choices.

Most likely to phone the reporting room were senior house officers, making up 45 percent of the caller pool, the authors said. Following the officers were registrars, at 18 percent, and foundation year 1s, other staff and consultants.

“Radiologists and referrers remain over-reliant on telephone interruptions for their workflow,” Watura and colleagues wrote. “Noninterpretive responsibilities now consume an oversized portion of reporting radiologists’ time and attention.”

To improve workflow in the radiology reporting room and increase efficiency, the authors suggested hospital officials define protected activities during which interruptions aren’t allowed, streamline radiologists’ and referrers’ workflow within electronic requesting and vetting processes, implement an electronic instant alert system for issuing critical reports and a review of report priority, and formalize a duty radiologist timetable to take on nonreporting responsibilities.