The Effectiveness of Service Delivery Initiatives at Improving Patients’ Waiting Times in Clinical Radiology Departments: A Systematic Review
OBJECTIVE To describe the authors' first year's experience with a picture archiving and communication system (PACS) for the management and storage of ultrasound images and to discuss the financial impact of the system in terms of costs of purchase, installation and operation. MATERIALS AND METHODS The Toronto Hospital, General Division, performs more than 30000 ultrasound studies each year. On June 27, 1994, an Ultra PACS (ALI Technology Incorporated, Richmond, BC) was introduced as the only method of image storage and archiving in the Ultrasound Division. RESULTS After structural renovations and a detailed work flow analysis, the Ultrasound Division converted from film to the PACS over a single weekend with no back-up. The advantages to date include consistently high-quality images; rapid image retrieval (images from the same day [online], 0 to 45 seconds; archived images [online], 3 to 5 minutes; images in storage [offline], 3 minutes); no loss of images; more efficient patient through-put, which allows the division to handle the same number of patients in 20% less operational time (change from a 10-hour day to an 8-hour day, over a 5-day week); less end-of-day overtime; and an improved work environment. There has been no change in the division's complement of full-time equivalent technologists, the number of film librarians has been reduced by 1, and physician service time has decreased by 20%. There has been no significant impact on overall operational financial status. CONCLUSION The PACS has proved an efficient method for managing large numbers of ultrasound images in a cost-effective and technically sound manner. Its installation provides the basis for meeting the Ultrasound Division's next objective, to eliminate paper as the primary method of managing patient information and reports.