Elsevier

Academic Radiology

Volume 18, Issue 6, June 2011, Pages 774-781
Academic Radiology

Radiologic education
Email Notification Combined with Off Site Signing Substantially Reduces Resident Approval to Faculty Verification Time

https://doi.org/10.1016/j.acra.2011.01.001Get rights and content

Rationale and Objectives

Attending radiologist signature time (AST) is a variable and modifiable component of overall report turnaround time. Delays in finalized reports have potential to undermine radiologists’ value as consultants and adversely affect patient care. This study was performed to evaluate the impact of notebook computer distribution and daily automated e-mail notification on reducing AST.

Materials and Methods

Two simultaneous interventions were initiated in the authors’ radiology department in February 2010. These included the distribution of a notebook computer with preloaded software for each attending radiologist to sign radiology reports and daily automated e-mail notifications for unsigned reports. The digital dictation system archive and the radiology information system were queried for all radiology reports produced from January 2009 through August 2010. The time between resident approval and attending radiologist signature before and after the intervention was analyzed. Potential unintended “side effects” of the intervention were also studied.

Results

Resident-authored reports were signed, on average, 2.53 hours sooner after the intervention. This represented a highly significant (P = .003) decrease in AST with all else held equal. Postintervention reports were authored by residents at the same rate (about 70%). An unintended “side effect” was that attending radiologists were less likely to make changes to resident-authored reports after the intervention.

Conclusions

E-mail notification combined with offsite signing can reduce AST substantially. Notebook computers with preloaded software streamline the process of accessing, editing, and signing reports. The observed decrease in AST reflects a positive change in the timeliness of report signature.

Section snippets

Materials and methods

This study was reviewed by the local institutional review board and was classified as an exempt study because it was analysis of existing administrative data. The study was also deemed to be compliant with the Health Insurance Portability and Accountability Act (HIPAA) by the associated privacy office.

Results

The query of the radiology database produced 461,916 reports with 293,434 (63.5%) before the intervention and 168,482 (36.5%) after the intervention. Table 1 shows the breakdown of these into the total number of resident-dictated reports and the number of resident-dictated reports changed by attending radiologists prior to signing (lnRAED >0). The distribution of all five categorical (control) variables is shown in Table 2. One notable difference from before to after the intervention was in the

Discussion

Many methods have been used to streamline radiology examination and reporting. Digital image generation, an integrated picture archiving and communication system and radiology information system, and the adoption of computer-based voice recognition have been shown to improve RTAT and have been used at our institution 5, 7. In an attempt to further improve AST, the component that most directly can be controlled by attending radiologists, additional interventions were explored to simplify and

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