title: Impact of a Reading Priority Scoring System on the Prioritization of Examination Interpretations.
abstract: OBJECTIVE
  Our institution implemented a read priority scoring system to combat the known limitations of traditional methods for the prioritization of examination interpretations by radiologists. We aimed to determine the impact on report turnaround time (RTAT) and RTAT variability.
  
  
  METHODS
  On examination completion, technologists entered a read priority score (1-9) using provided definitions. We retrospectively reviewed the median RTAT and RTAT variability (i.e., interquartile range length) for radiology examinations (n = 615,541; 2011-2014). We used Spearman correlation coefficients to determine the relationships between read priority scores and the median RTAT and the RTAT variability by year. We compared median RTAT and RTAT variability between early (2011) versus late (2012-2014) adoption phases using distribution-free random permutation tests.
  
  
  RESULTS
  Ranked correlations showed yearly improvement, leading to a near-perfect ranking of median RTAT (r = 0.98, p < 0.001) and a perfect ranking of RTAT variability (r = 1.00, p < 0.001) by nine levels of priority. Eight of the nine priority levels showed a reduction in median RTAT between the early and late phases, and the three most urgent levels--that is, 1, 2, and 3--improved by 23%, 5%, and 70% (all, p < 0.001), respectively. Only one priority level (4, defined as outpatient urgent [8% of studies]) showed significant worsening by 15% (p < 0.001). The three most urgent levels of priority also showed improvements in RTAT variability (61%, 17%, 71%, respectively; all, p < 0.01). Only the lowest level of priority (9) exhibited a significant worsening in RTAT variability by 9% (p < 0.01).
  
  
  CONCLUSIONS
  A reading priority scoring system with defined clinical scenarios yielded desirable prioritization of examination interpretations by radiologists as evidenced by appropriate and improved stratification of RTATs and RTAT variability.
authors.affiliation: 1 Department of Radiology and Medical Imaging, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
authors.forename: Cree M
authors.initials: CM
authors.lastname: Gaskin
authors.affiliation: 2 Department of Health Evaluation Sciences, University of Virginia Health System, Charlottesville, VA.
authors.forename: James T
authors.initials: JT
authors.lastname: Patrie
authors.affiliation: 1 Department of Radiology and Medical Imaging, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hanshew
authors.affiliation: 1 Department of Radiology and Medical Imaging, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
authors.forename: Dustin M
authors.initials: DM
authors.lastname: Boatman
authors.affiliation: 1 Department of Radiology and Medical Imaging, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: McWey
mesh_terms: D003952:Diagnostic Imaging; D006292:Health Priorities; D006801:Humans; D008499:Medical Records / Q000592:standards*; D017146:Models, Organizational; D011871:Radiology / Q000458:organization & administration*; D011873:Radiology Information Systems / Q000458:organization & administration; D012189:Retrospective Studies; D013997:Time Factors
keywords: prioritization; read priority; reading priority; report turnaround time; stat