Interventional radiologists finish 87% of procedures by 5 PM with new workflow
Reimagining daily workflows instead of boosting staffing levels can help curtail burnout among interventional radiologists and other physicians, according to a new pilot study.
Providers across most medical specialties are tired, and the pandemic has only accelerated this problem. The IR culture is also contributing, as a lack of role clarity and accountability drives up work hours for everyone on the team.
Given these growing issues, Stanford Medicine experts piloted a new work paradigm, detailing their efforts in the Journal of Vascular and Interventional Radiology.
“A change in the IR practice model is proposed, drawing parallels from the hospitalist and laborist model, one where individuals focus on predetermined tasks without other competing duties,” Eric T. Foo, MD, and colleagues at Stanford explained July 20. “It was hypothesized that by streamlining flow through the IR suite, schedule predictability and work-life balance could be improved, without impacting patient care, practice volume or costs.”
The group instituted four true workflow changes in the fall of 2019.
First, one of the four angiographic suites was dedicated solely to inpatient services, leaving the other three for outpatients. Second, morning rounds were moved up from 7:30 a.m. to 7:15 a.m. on Tuesdays and Thursdays and shortened by 15 minutes. Third, outpatient scheduling became a semi-automated (as opposed to manual) process using physician-specific data to determine case length time. Finally, patients were provided their check-in time 24 hours before the procedure to help schedulers close gaps and staff appropriately.
Foo and co-authors compared pre-process data from January to October 2019 against post-implementation metrics from December 2019 to September 2020. This included COVID-19 surges, the group noted, but didn’t count weekend and after-hour procedures.
In total, there were 4,373 and 4,198 weekday procedures in the pre-and post-intervention periods, respectively. Encounters within the latter time frame more often started within 15 minutes of the scheduled time block (72% of procedures vs. 56%).
Furthermore, the group reported a slight improvement in procedures completed within providers’ allotted time frame.
Perhaps most importantly, physicians assigned to outpatient services finished their final case by 5 p.m. in 87% of instances in the post-intervention period. The old workflow, meanwhile, only saw 53% finished by that hour.
While this single-center project may not apply to all organizations or specialties, the focus on workflow rather than staffing may be key to helping the next generation of providers.
“With an evolving medical practice, predictability and work-life balance are becoming increasingly important,” the authors noted. “Rather than ignore this change in mindset, one must embrace these changes and adapt to identify areas to improve workflow efficiency,” they added later.
Read the full study here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.