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Eight tips to improve MRI throughput

Radiology Administrator's Compliance and Reimbursement Insider, August 1, 2008

As reimbursements shrink and radiology becomes more competitive, smart radiology practice administrators should determine how to best serve as many patients as possible without sacrificing the quality of patient care, says Mary Ellen Tobey, RT (R)(M), client services manager at North Shore Magnetic Imaging Center (NSMIC) in Peabody, MA. To increase MRI throughput, you need to review all aspects of your practice in detail. Just adding one MRI exam to your center’s schedule every day can make a big difference, says David A. Dierolf, director of performance improvement at Outpatient Imaging Affiliates, LLC, in Nashville. As a modality, an MRI generates significant income, and it’s worth it for your facility to take a hard look at throughput, he adds. (See p. 5 for a model staff memo you can use to flag safety issues and avoid scheduling an MRI that a patient can’t have for safety or medical necessity reasons.) The following are eight tips to improve your MRI throughput:

1. Analyze productivity. Look at the care patients receive from the time they walk in the door until the time they leave, says Tobey. Gather information and examine any and all appropriate data regarding staff production. Don’t guess, she says.

NSMIC uses a radiology information system to make gathering data easier. Most administrative tasks are automated and computerized, and patient information is readily available on the system, Tobey says. By analyzing patient information, the facility can track any organizational inefficiencies, she says. With a paperless system, keeping track of patient records is more efficient, and it is easy to analyze and immediately determine who worked with which patient if a problem arises.

In addition, Tobey recommends investing in an automatic call distributor (ACD) to disperse incoming patient calls to staff members so they can schedule appointments efficiently. The ACD can track how many patient calls go unanswered and help you to identify the time when your facility receives the greatest number of patient calls. Also, in a growing practice, the ACD will allow you to analyze data to determine what your hiring needs are.

2. Gather information before appointments. Make sure you have all patients’ information, including the referral, demographic information, risk factors, and insurance approval, before they come in the door, says Dierolf. If possible, get this information via e-mail, and make sure it protects patient confidentiality, says Tobey.

3. Optimize length of appointment. Ensure that your staff members set the right amount of time needed for MRI appointments, says Dierolf. If you set too little time, patients feel rushed, and your office gets backlogged. But setting too much time could cause you to lose potential patients and possible reimbursement dollars. Because every practice is different, analyze the optimum operation times for MRIs at your facility.

4. Confirm appointments in advance. Remind patients of their appointments two days in advance. This way, if you have a cancellation, you have enough room to book another appointment in that time slot.

5. Flag safety risks prior to appointment. Make sure staff members note any potential MRI safety risks before patients enter the facility for their MRIs. Implanted items such as pacemakers or other devices that people may have make it unsafe for them to have MRIs, says Tobey. You also do not want to waste the patients’ time. And, in the tightening reimbursement environment, every MRI appointment slot is precious, says Dierolf. Your staff members must know the right questions to ask patients before their appointments. (To help you do this, refer to “Model memo for MRI patient safety” below.)

6. Fill in cancellations. Make the most of your center’s time by filling up the schedule as much as you can, says Dierolf. Although you can’t avoid some last-minute cancellations, if a patient cancels in advance, you may want to call patients scheduled later in the week and ask whether they want to come in earlier, he says.

7. Ensure that trained staff members meet with patients before they enter the MRI. Schedule sufficient one-on-one time with patients, says Tobey. You need to review the patients’ medical and clinical history and again ensure that there are no risk factors.

Remind patients to remove all metal items before undergoing an MRI. Currently, body piercings have been a big issue, says Tobey. Remind patients to remove their piercings and other metal items, such as hair clips, before their appointments.

8. Extend operating hours. Consider adding some evening or weekend hours to your facility, Dierolf says. The extra costs associated with this will be offset by the extra MRI profits, he says. It also creates an added convenience for patients who cannot take time off from work.

Tip: Hiring an extra staff person to increase efficiency will most likely be worth the money for your practice. The income generated by the extra MRI appointments, even if you only add one MRI per day, will more than pay for the additional staff member’s salary, says Dierolf.

Insider sources

David A. Dierolf, director of performance improvement, Outpatient Imaging Affiliates, LLC, 104 Woodmont Boulevard, Suite 320, Nashville, TN 37205, 434/806-3458; ddierolf@oiarad.com.

Mary Ellen Tobey, North Shore Magnetic Imaging Center, 68 Prospect Street, Peabody, MA 01960, 978/532-8960; metobey@nsmig.org.

Model memo for MRI patient safety

The following is a model memo to staff members outlining the necessary information to help them improve MRI throughput. Speak with your hospital’s attorney about using this sample memo in your facility.

To: Staff members

From: Radiology administrator

Date: _________

Re: Getting patient information in advance

1. Please call patients to confirm their appointments 48 hours in advance.

2. Ensure that the following information is in the patient’s file: Correct address, allergies, referral, and health information (see #4).

3. If patients are having a contrast scan, remind them not to eat the morning before.

4. If a patient is having an MRI, ask the patient whether he or she has any of the following and check any applicable items:

  • Cardiac pacemaker
  • Aneurysm clip in brain (or surgery for cerebral aneurysm)
  • Neurostimulator
  • Dental magnet
  • Coronary artery stent
  • Implanted heart defibrillator
  • Implanted pacing leads or wires
  • Bullets, shrapnel, or bullet fragments
  • Cochlear implant
  • Cataract lens implant
  • Insulin pump