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



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.


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.


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).


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

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Data availability

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


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Author information




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.

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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).

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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 (2020). https://doi.org/10.1007/s10140-020-01803-3

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  • Emergency department
  • Staffing
  • Crowding
  • Imaging
  • Radiology turnaround time
  • Quality improvement