title: Reducing Functional MR Imaging Acquisition Times by Optimizing Workflow.
abstract: Functional magnetic resonance (MR) imaging is a complex, specialized examination that is able to noninvasively measure information critical to patient care such as hemispheric language lateralization ( 1 ). Diagnostic functional MR imaging requires extensive patient interaction as well as the coordinated efforts of the entire health care team. We observed in our practice at an academic center that the times to perform functional MR imaging examinations were excessively lengthy, making scheduling of the examination difficult. The purpose of our project was to reduce functional MR imaging acquisition times by increasing the efficiency of our workflow, using specific quality tools to drive improvement of functional MR imaging. We assembled a multidisciplinary team and retrospectively reviewed all functional MR imaging examinations performed at our institution from January 2013 to August 2015. We identified five key drivers: (a) streamlined protocols, (b) consistent patient monitoring, (c) clear visual slides and audio, (d) improved patient understanding, and (e) minimized patient motion. We then implemented four specific interventions over a period of 10 months: (a) eliminating intravenous contrast medium, (b) reducing repeated language paradigms, (c) updating technologist and physician checklists, and (d) updating visual slides and audio. Our mean functional MR imaging acquisition time was reduced from 76.3 to 53.2 minutes, while our functional MR imaging examinations remained of diagnostic quality. As a result, we reduced our routine scheduling time for functional MR imaging from 2 hours to 1 hour, improving patient comfort and satisfaction as well as saving time for additional potential MR imaging acquisitions. Our efforts to optimize functional MR imaging workflow constitute a practice quality improvement project that is beneficial for patient care and can be applied broadly to other functional MR imaging practices.©RSNA, 2017.
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: Wilson B
authors.initials: WB
authors.lastname: Chwang
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: Michael
authors.initials: M
authors.lastname: Iv
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: Jason
authors.initials: J
authors.lastname: Smith
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: Aleksandrs
authors.identifier: http://orcid.org/0000-0001-6951-4964
authors.initials: A
authors.lastname: Kalnins
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: Jake
authors.initials: J
authors.lastname: Mickelsen
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: Roland
authors.initials: R
authors.lastname: Bammer
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: Dominik
authors.initials: D
authors.lastname: Fleischmann
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: David B
authors.initials: DB
authors.lastname: Larson
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: Max
authors.initials: M
authors.lastname: Wintermark
authors.affiliation: From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
authors.forename: Michael
authors.initials: M
authors.lastname: Zeineh
mesh_terms: D002140:California; D057189:Checklist / Q000706:statistics & numerical data*; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D011872:Radiology Department, Hospital / Q000706:statistics & numerical data*; D057188:Workflow; D016526:Workload / Q000706:statistics & numerical data*