Skip to main content
Log in

Lean-driven interventions, including a dedicated radiologist, improve diagnostic imaging turnaround time and radiology report time at the emergency department

  • Original Article
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract

Purpose

Emergency departments (EDs) worldwide face crowding, which negatively affects patient care. Diagnostic imaging plays a major role in management of ED patients and contributes to patients’ length of stay at the ED. In this study, the impact of Lean-driven interventions on the imaging process at the ED was assessed.

Methods

During a 6-month multimodal intervention period, Lean-driven interventions and a dedicated radiologist present at the ED were implemented during peak hours (12 a.m.–8 p.m.). Data concerning patient population, radiology department turnaround time (RDTT), radiology report time (RRT), and examination time (ET) for ED patients were compared with a control period of 6 months 1 year earlier.

Results

RDTT, RRT, and ET were significantly shorter in the intervention period compared with those in the control period. Median RDTT was respectively 36 min (interquartile range (IQR) 24–56) and 70 min (IQR 39–127), RRT 11 min (IQR 6–21) and 37 min (IQR 15–88), and ET 22 min (IQR 14–35) and 23 min (14–38).

Conclusion

Lean-driven interventions on the imaging process at the ED significantly reduced RDTT, RRT, and ET.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author, BK, upon reasonable request.

References

  1. Carter EJ, Pouch SM, Larson EL (2014) The relationship between emergency department crowding and patient outcomes: a systematic review. J Nurs Scholarsh 46:106–115

    Article  Google Scholar 

  2. Pines JM, Griffey RT (2015) What we have learned from a decade of ED crowding research. Acad Emerg Med 22:985–987

    Article  Google Scholar 

  3. Derlet RW, Richards JR (2002) Emergency department overcrowding in Florida, New York, and Texas. South Med J 95:846–849

    Article  Google Scholar 

  4. Van der Linden C, Reijnen R, Derlet RW, Lindeboom R, Van Der Linden N, Lucas C et al (2013) Emergency department crowding in the Netherlands: managers’ experiences. Int J Emerg Med 6:41

    Article  Google Scholar 

  5. DeFlorio R, Coughlin B, Coughlin R, Li H, Santoro J, Akey B, Favreau M (2008) Process modification and emergency department radiology service. Emerg Radiol 15:405–412

    Article  Google Scholar 

  6. White BA, Yun BJ, Lev MH, Raja AS (2017) Applying systems engineering reduces radiology transport cycle times in the emergency department. West J Emerg Med 18:410–418

    Article  Google Scholar 

  7. Dang W, Kielar AZ, Fu AYN, Chong ST, McInnes MD (2015) Does distance matter? Effect of having a dedicated CT scanner in the emergency department on completion of CT imaging and final patient disposition times. J Am Coll Radiol 12:277–283

    Article  Google Scholar 

  8. Kocher KE, Meurer WJ, Desmond JS, Nallamothu BK (2012) Effect of testing and treatment on emergency department length of stay using a national database. Acad Emerg Med 19:525–534

    Article  Google Scholar 

  9. Van Der Linden MC, De Beaufort RAY, Meylaerts SAG, Van Den Brand CL, Van Der Linden N (2019) The impact of medical specialist staffing on emergency department patient flow and satisfaction. Eur J Emerg Med 26:47–52

    Article  Google Scholar 

  10. Dickson EW, Singh S, Cheung DS, Wyatt CC, Nugent AS (2009) Application of Lean manufacturing techniques in the emergency department. J Emerg Med 37:177–182

    Article  Google Scholar 

  11. Hitti EA, El-Eid GR, Tamim H, Saleh R, Saliba M, Naffaa L (2017) Improving emergency department radiology transportation time: a successful implementation of lean methodology. BMC Health Serv Res 17:625. https://doi.org/10.1186/s12913-017-2488-5

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rogg JG, Huckman R, Lev M, Raja A, Chang Y, White BA (2017) Describing wait time bottlenecks for ED patients undergoing head CT. Am J Emerg Med 35:1510–1513

    Article  Google Scholar 

  13. Lamb L, Kashani P, Ryan J, Hebert G, Sheikh A, Thornhill R, Fasih N (2015) Impact of an in-house emergency radiologist on report turnaround time. CJEM 17:21–26

    Article  Google Scholar 

  14. Towbin AJ, Iyer SB, Brown J, Varadarajan K, Perry LA, Larson DB (2013) Decreasing variability in turnaround time for radiographic studies from the emergency department. RadioGraphics 33:361–371

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

Each author had a substantial contribution and met the requirements for authorship. The manuscript has been read and approved by all the authors.

Corresponding author

Correspondence to Bente M. de Kok.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This is an observational study. The Southwest Holland Ethics Committee has confirmed that no ethical approval is required (nr. 17-122).

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Kok, B.M., Eijlers, B., van der Linden, M.C. et al. Lean-driven interventions, including a dedicated radiologist, improve diagnostic imaging turnaround time and radiology report time at the emergency department. Emerg Radiol 28, 23–29 (2021). https://doi.org/10.1007/s10140-020-01803-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-020-01803-3

Keywords

Navigation