Nosheen Fatima, Maseeh-uz Zaman, Sif Siddiqui M Wasif, Mirza Rehan Baig.
Report turnaround time (RETAT) in a nuclear medicine department: root cause analysis and actions plans for procedures reported beyond benchmark.
Pak J Radiol Jan ;28(2):120-3.

Abstract Background: Report turn-around time (ReTAT) is an important indicator of quality healthcare. Availability of effective hardware and software technologies have shortened ReTAT from hours to minutes. Purpose of this audit in a nuclear medicine section was to explore the reasons for small percentage of procedures reported beyond the benchmark and to make strategies to avoid such delays. Material and Method: This audit was conducted at Nuclear Medicine section of Aga Khan University Hospital Karachi, Pakistan and ReTAT data from 1.1.2017 till 30.11.2017 was collected. %ReTAT within and beyond institutional benchmark were analyzed. Root cause analyses (RCA) for delays were done and strategies to avoid such delays were made. Results: During study period total 5905 procedures were performed (Outpatient clinic: 2811; Outside referral: 2828; In-patient: 262; Emergency Room: 04). Overall %ReTAT within benchmark was 97.15% (range: 95.15 - 100%) and for ER procedures it was 100%. ReTAT beyond benchmark was found in 168 (2.85%) procedures. Delay was considered justified for procedures with imaging protocols beyond 24 hour in 55/168 (33%). In 113/168 (67%) procedures, delays were considered unjustified caused by either prior registration or delayed submission of patients` files to reporting suite. For justified delays and prior registration we have made a strategy to acknowledge these procedures in RIS. For delayed submission of patients` folder to reporting suites, allocation of scans according to duty roster into the bin of reporting physician and system generated alerts to NM section head for un-reported procedures 8 hour after registration are planned. The impact of these strategies will be evaluated in a follow-up audit. Conclusion: A timely available imaging report has a significant impact upon patient`s management. Our %ReTAT is well within institution`s bench mark (around 97% against >90% benchmark). By conducting this audit we performed root cause analyses for small percentage of procedures reported beyond ReTAT benchmark. We have made strategies for each explored cause and planned to perform a follow-up audit to measure the target outcomes.

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