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scheduling
I was wondering what the scheduling is like at other facilities. I've worked in Doctor's offices, Imaging Centers, and Hospitals and the over booking of exams is becoming abusive. It used to be 30 minutes per exam, be it ABD, OB, Carotid or ECHO, but now it is every 15 min.
Didn't there used to be exam time guidelines for accredited facilities?
Why can't AIUM follow the lead of American Society of Echocardiography
Q: Are there standards of case loads for cardiac sonographers?
A: There have been a few surveys over the past few years which gathered data on the average number of cases sonographers would perform in a day. The data from the 2010 ASE survey showed that the number of scans varied per day, though the majority of sonographers performed more than 6 scans per day. The most frequently reported number of scans was 8 per day. The average per day in a hospital setting was 6. Please note that the number of pediatric studies is lower. Other surveys we have come across also validate the ASE survey results. The only true "standard" which exists is the ICAEL lab accreditation standards. The ASE, as a sponsoring organization, supports those standards as good practice to maintain quality. These standards suggest allowing a minimum of 45-60 minutes for an uncomplicated transthoracic case, and possibly another 15 - 30 minutes for a complicated case. This standard would fall into line with the benchmark data survey results of the most common number of studies per day at 8-10. The other issue to not leave out of any discussion of number of cases per day is the physical effects of scanning too many patients per day. Many well known speakers on the subject of musculoskeletal injury in scanning recently quote statistics of a dramatic increase in the incidence of injury when sonographers perform more than 10 studies per day. One other suggestion to make in comparing case volumes, is to look to other neighboring or regional labs to see what they are doing. This benchmark data can offer a lot of relevant information.
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Replies to This Discussion
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Permalink Reply by Paula Woletz on -
I can't speak for other accreditation programs, but AIUM accreditation has never had exam time guidelines.
Frankly, I can't imagine coming up with a one-size-fits-all time guideline, because exam time can be affected by the types of scans the practice provides, each practice's exam guidelines, the patient population (body habitus, high- versus low-risk population, etc.), equipment, sonographer experience, and any non-scanning responsibilities that may affect workflow.
Now I'm taking off my AIUM hat and expressing my personal concerns for situations like yours:
I worry that by not providing sufficient time, exam quality (and therefore patient care) may suffer because the staff is rushed, sonographers may be at risk of developing work-related musculoskeletal disorders, and a single complicated case may result in a crowded waiting room filled with anxious and unhappy patients whose own exams are delayed.
I wish I could offer more concrete assistance.
Paula
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Permalink Reply by Todd Rafferty on -
I was expressing frustrations as well. If a location is accredited it is unbelievable that overworking, exploiting, and abusing the technologists performing the exams is not even figured into the equation. For the propaganda of providing proper patient care an accreditation institute wants to know all kinds of variables that are senseless when compared to the health and safety of the technologist proving the care. I'm sure it is the same for all professions as I've known many nurses that quit because of the same issues.
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Permalink Reply by Jesse Witcraft on -
I agree. I think the physicians ordering these exams are being pressured by admistrative groups to improve volumes and revenues, inturn are ordering far more exams that are unecessary. Somtimes a way for them to deal with their increase in patient volumes, they order tests to hopefully give them an easy answer to the patients intial complaint, that way they may not have to clinically rely on there own diagnostic theory, but rather the radiologists. keeps the lawsuits down, I believe.
So I would say facilities need to hire more techs. with the less expensive of most modalities ( ultrasound) the increase is going to continue and the volumes are going to increase as well. ( good job security? ) or keep all exams regardless of modality at 45 minute slots. this would keep techs healthier and more cabable of working more years in the industry.
good luck -
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Permalink Reply by Alain Herbert Szyller on
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It would be interesting to have a survey about the average time required for each subtype of ultrasound.
For example, as an ObGyn I would feel that a dating OB less than 10 weeks usg or a follicular stim.follow/up require each less than 10 minutes, whereas an anatomy scan requires 20 to 30 minutes, and any other OBGyn sono would be in between those extremes (excepted multi-fetal pregnancies).
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