Breast imaging clinic closely monitors workflow to improve efficiency

A hospital-based breast imaging clinic implemented a real-time location system (RTLS) to track its workflow, learning important information that will lead to better patient care moving forward. The team behind the project, including first author Tali Amir, MD, of Memorial Sloan Kettering Cancer Center in New York City, published its findings in the Journal of Digital Imaging.

“Value in health care is defined as quality relative to cost and therefore is closely linked to efficiency in radiology workflow,” the authors wrote. “The workflow of an imaging facility impacts both patient experience and practice efficiency.” 

The RTLS helped the clinic track both its assets and its employees for 10 weeks to see where workflow improvements were needed to improve patient care. (The RTLS tracks locations and time spent in those locations, but it does not record specific data). The clinic in question provides full-field digital mammography (FFDM), digital breast tomosynthesis (DBT) and ultrasound and had a reputation for long wait times. Equipment includes two FFDM units, one DBT unit and two ultrasound rooms.

One key finding, the authors explained, was that the mean patient time in the waiting room was 27 minutes. Also, the mean patient time in the dressing room was 12 minutes. In addition, the DBT exam room had the highest overall patient utilization at 32 percent. Utilization was highest from 8 a.m. to 12 p.m.

Determining that the DBT room was a bottleneck slowing down patient care, the authors determined that one FFDM unit should be replaced with a DBT unit and that an additional mammography technologist should be brought in. The limited DBT equipment was harming patient throughput, the authors noted, and the fact that the FFDM equipment was older was leading more patients to recommend DBT.

“For mammogram only patients, a 19.2 percent reduction in length of stay is predicted with the replacement of one FFDM unit with a DBT unit and the addition of one mammography technologist,” the authors wrote. “For patients who undergo mammogram and ultrasound or ultrasound alone, 18.7 percent and 17.5 percent reductions in length of stay are predicted, respectively with an additional DBT unit (to replace an FFDM unit) and both a mammogram technologist and a dual trained technologist.”