MRI prioritization necessary to reduce Canadian wait times
While Canada might lag behind other countries in the number of diagnostic imaging devices, more machines are not the only solution to long wait times, according to a study conducted at the University of Calgary in Alberta, Canada.
"This study shows there are important deficiencies in the current system. We hope this research will help health system decision-makers and managers improve the provision of this important service," said the study's senior author Thomas E. Feasby, MD, professor in the department of clinical neurosciences at the University of Calgary, published in this month's Healthcare Policy.
To determine how requests for MRI studies are managed, the authors surveyed all public MRI facilities in Canada; they identified 122 publicly funded facilities with MIR scanners and of those, 79 responded to the survey. Of the 79 responding centers, 58 had one MRI scanner, 18 had more than one and three centers relied on portable scanners that visited on a regular basis.
Ninety-six percent of centres used some method to triage requests for MRI studies to different priority levels. Ninety-six percent identified clinical urgency as the primary factor that determined priority. However, only 42 percent had explicit, documented criteria to guide the prioritization process. Prioritization was usually based on implicit assessments by the radiologist, using a handwritten requisition submitted by an ordering physician.
"Our results document that most MRI facilities in Canada have a substantial wait list problem, with some centers reporting wait times of up to one month for urgent scans and up to several years for non-urgent scans. Despite the magnitude of these wait times and recognition of the problem by staff at the facilities, strategies used to manage wait lists and reduce wait times are diverse, uncoordinated and, judging by the number of patients on the wait lists, largely ineffective," the authors wrote.
The researchers concluded that improvement in wait list management is critical to reducing wait times to improve access, fairness and quality in the provision of MRI services in Canada. View the study in its entirety.
"This study shows there are important deficiencies in the current system. We hope this research will help health system decision-makers and managers improve the provision of this important service," said the study's senior author Thomas E. Feasby, MD, professor in the department of clinical neurosciences at the University of Calgary, published in this month's Healthcare Policy.
To determine how requests for MRI studies are managed, the authors surveyed all public MRI facilities in Canada; they identified 122 publicly funded facilities with MIR scanners and of those, 79 responded to the survey. Of the 79 responding centers, 58 had one MRI scanner, 18 had more than one and three centers relied on portable scanners that visited on a regular basis.
Ninety-six percent of centres used some method to triage requests for MRI studies to different priority levels. Ninety-six percent identified clinical urgency as the primary factor that determined priority. However, only 42 percent had explicit, documented criteria to guide the prioritization process. Prioritization was usually based on implicit assessments by the radiologist, using a handwritten requisition submitted by an ordering physician.
"Our results document that most MRI facilities in Canada have a substantial wait list problem, with some centers reporting wait times of up to one month for urgent scans and up to several years for non-urgent scans. Despite the magnitude of these wait times and recognition of the problem by staff at the facilities, strategies used to manage wait lists and reduce wait times are diverse, uncoordinated and, judging by the number of patients on the wait lists, largely ineffective," the authors wrote.
The researchers concluded that improvement in wait list management is critical to reducing wait times to improve access, fairness and quality in the provision of MRI services in Canada. View the study in its entirety.