Development of a Medical Radiology Service Guideline during the COVID-19 Pandemic at Amnatcharoen Hospital.
Keywords:
Medical radiology, COVID-19, Chest radiography, Teleradiology, Quality improvementAbstract
This action research by before-and-after study aimed to identify service problems, develop a medical radiology service guideline, and evaluate its outcomes at Amnatcharoen Hospital. The patient sample consisted of 1,182 patients undergoing chest radiography, including 570 before implementation and 612 after implementation. Forty-four involved health personnel completed the satisfaction assessment. The developed service model integrated Patient Identification, the Remote Chest Stand of Amnatcharoen, Mobile X-ray Service, X-Ray Drive Thru for Community Isolation and Home Isolation, PACS/Teleradiology, and an Alert System. Data were collected using repeat radiography records, Workflow time records, resource-use records, and a personnel satisfaction questionnaire. Descriptive statistics, chi-square test, and independent samples t-test with Welch correction were used for analysis.
The chest radiography Repeat Rate decreased from 3.46% to 1.45%, representing a 58.09% reduction, with statistical significance (p=0.037). The mean total service time decreased from 46.0±8.6 minutes to 13.0±4.1 minutes, representing a 71.74% reduction (p<0.001). Full-PPE use decreased by 30 sets per month, equivalent to a cost reduction of 4,500 baht per month. Overall personnel satisfaction was at a high level, with a mean score of 4.31±0.45. The findings indicate that a medical radiology service guideline integrating radiographic innovation and digital Workflow can reduce Workflow bottlenecks, repeat imaging, service time, and resource use while supporting staff safety during a public health emergency.
References
Akudjedu TN, Mishio NA, Elshami W, Culp MP, Lawal O, Botwe BO, et al. The global impact of the COVID-19 pandemic on clinical radiography practice: a systematic literature review and recommendations for future services planning. Radiography. 2021;27(4):1219-1226.
Mc Fadden S, Flood T, Shepherd P, Gilleece T. Impact of COVID-19 on service delivery in radiology and radiotherapy. Radiography. 2022;28 Suppl 1:S16-S26.
Goyal A, Tiwari R, Bagarhatta M, Ashwini B, Rathi B, Bhandari S. Role of portable chest radiography in management of COVID-19: experience of 422 patients from a tertiary care center in India. Indian J Radiol Imaging. 2021;31 Suppl 1:S94-S100.
Inui S, Gonoi W, Kurokawa R, Nakai Y, Watanabe Y, Sakurai K, et al. The role of chest imaging in the diagnosis, management, and monitoring of coronavirus disease 2019 (COVID-19). Insights Imaging. 2021;12(1):155. doi:10.1186/s13244-021-01096-1.
Jastaniyyah DF, Jawhari AA, Mugharbel AT, Khafaji MA, Albahiti SH. How has the COVID-19 pandemic affect the rejection rates and repeat reasoning of digital radiography? Saudi Med J. 2021;42(9):1041-1044.
Martín-Noguerol T, Lopez-Ortega R, Ros PR, Luna A. Teleworking beyond teleradiology: managing radiology departments during the COVID-19 outbreak. Eur Radiol. 2021;31(2):601-604.
Ain HQU, Tahir MJ, Waheed S, Ahmad S, Ullah I, Yousaf Z. Teleradiology in COVID-19: a sustainable innovative solution. Acad Radiol. 2021;28(9):1325-1326. doi:10.1016/j.acra.2021.06.020.
Chang G, Doshi A, Chandarana H, Recht M. Impact of COVID-19 Workflow changes on patient throughput at outpatient imaging centers. Acad Radiol. 2021;28(3):297-306.
Abuzaid MM, Elshami W, McConnell J, Tekin HO, Issa B, Al Kawas S. Infection control and radiation safety practices in the radiology department during the COVID-19 outbreak. PLoS One. 2022;17(12):e0279607.
Tay YX, Kothan S, Kada S, Cai S, Lai CWK. Challenges and optimization strategies in medical imaging service delivery during COVID-19. World J Radiol. 2021;13(5):102-121.
Reeves JJ, Hollandsworth HM, Torriani FJ, Taplitz R, Abeles S, Tai-Seale M, et al. Rapid response to COVID-19: health informatics support for outbreak management in an academic health system. J Am Med Inform Assoc. 2020;27(6):853-859.
AlQudah AA, Al-Emran M, Shaalan K. Technology acceptance in healthcare: a systematic review. Appl Sci. 2021;11(22):10537.
Sim WY, Chen RC, Aw LP, Abu Bakar R, Tan CC, Heng AL, et al. How to safely and sustainably reorganise a large general radiography service facing the COVID-19 pandemic. Radiography. 2020;26(4):e303-e311.
Yusoff MSB. ABC of content validation and content validity index calculation. Educ Med J. 2019;11(2):49-54.
Bujang MA, Omar ED, Foo DHP, Hon YK. Sample size determination for conducting a pilot study to assess reliability of a questionnaire. Restor Dent Endod. 2024;49(1):e3.
