Delays are common with sedated MRIs. Standardized workflow protocols could help avoid them
Implementing standardized processes for MRI exams requiring any form of sedation can significantly reduce workflow delays.
In some cases, MRI with sedation can delay workflows by 60 minutes or more, putting staff and patients in a bind. Many of these delays are owed to a lack of standardized procedures that include everyone involved in the process—administrative staff, techs, anesthesia personnel, radiologists and even the patients themselves.
At National University Hospital in Singapore, a quality control analysis uncovered numerous hiccups in the radiology department’s sedation MRI protocols. These issues touched on everything from information provided by the ordering physician to scheduling conflicts, patient transfer, informed consent and processes related to admission. Many staffers were not aware that patients undergoing sedation for imaging were required to be admitted to the hospital temporarily.
The large organization conducts more than 30,000 MRI scans annually, making workflow delays costly for both patients and the facility itself. Between the winter of 2022 and summer of 2023, nearly 72% of all sedated MRI exams were delayed by at least 15 minutes, while 28% were delayed by an hour or more.
The department developed a process to streamline workflows for imaging that required anesthesia. The protocol aimed to standardize the entire process from start to finish, specifically targeting pre-admission patient counseling, adherence to scheduled scan times and written consent.
After deploying the intervention, the department conducted an analysis of all MRIs requiring sedation over a period of 18 months, 443 of which were done prior to implementing workflow protocols and 184 that were done after.
The intervention significantly improved workflow delays. Post-implementation, there was a 34.7%-point reduction in scans delayed by over 15 minutes and a 7.5%-point drop in exams delayed by an hour or longer. Overall, the team observed a reduced median delay time by 15 minutes.
Although the intervention was effective, the authors acknowledge that some delays are inevitable—sedation MRIs are not scheduled nearly as often as routine scans, so it’s understandable that staff might not remember every step every time.
Turnover can also impact workflow, as new staff must be trained in numerous workflow protocols and would likely require multiple interactions with the sedation MRI process.
The intervention is not foolproof, but it could be used as a starting point, the group suggests.
“Other methods of increasing the impact of our interventions, such as integrating the workflow into our hospital electronic medical records and educating patients, are possible future strategies,” corresponding author Aric Lee, MBBS, and colleagues suggest. “Further work could also explore the adaptability of our QI interventions across different imaging modalities or in diverse healthcare settings, such as regional hospitals within our network, to further enhance healthcare delivery.”
Learn more about the intervention in the Journal of the American College of Radiology.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.