Effects of Interpersonal Skills Training on MRI Operations in a Saturated Market: A Randomized Trial

Abstract

Purpose: The aim of this study was to assess the effects of team training on operational efficiency during outpatient MRI.

Methods: In this institutional review board-approved, HIPAA-compliant study, six MRI outpatient sites of a midwestern hospital system were randomized to serve as controls or have their teams trained in advanced communication skills. The fourth quarter of fiscal year 2015 was the trial baseline. The trial ended in the third quarter (Q3) of fiscal year 2016 (FY16). Equipment utilization (completed scans/available slots), hourly scan rates (total orders completed per machine per hour of operation), and no-show rates stratified by time were analyzed using the Cochran-Mantel-Haenszel method, with individual comparisons performed with Bonferroni correction.

Results: The study encompassed 27,425 MRI examinations. Overall volume peaked at baseline and then declined over the following quarters. Compared with baseline, untrained sites experienced significant drops in equipment utilization (P < .01 for the first quarter of FY16 and P < .0001 for the second quarter of FY16 and Q3 FY16), decreasing from 77% to 65% over the study period, corresponding to a decrease from 1.15 to 0.97 in hourly scan rates. For trained sites, these metrics showed no significant change, with maintenance of hourly scan rates of 1.23 and 1.27 and equipment utilization rates of 83% and 85% between baseline and Q3 FY16. No-show rates remained stable at trained sites but increased at untrained sites in the last two quarters (P < .05). Nationally benchmarked patient satisfaction percentile ranking gradually increased at trained sites from 56th at baseline to 70th and successively decreased at untrained sites from 66th to 44th.

Conclusions: MRI outpatient facilities trained in advanced communication techniques may have more favorable operational efficiency than untrained sites in a saturated market.

Keywords: Interpersonal skills; MRI; communication; equipment utilization; patient satisfaction.

Conflict of interest statement

Conflict of Interest:

Elvira Lang, MD: Founder and President, Hypnalgesics, LLC

Nothing to disclose for any of the remaining authors.

Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Figures

Fig 1

Equipment utilization rates at trained and untrained sites over time. Since the slot length was stable at 0.67 hours for all sites throughout the trial, hourly scan rate (total orders completed per machine hour of operation) is equal to the equipment utilization rate multiplied by 1.5. Thus a 100% scan utilization rate would equal a 1.5 hourly scan rate. Error bars denote 95% confidence intervals for proportions based on the binomial distribution.

Fig 2

No-show rates at trained and untrained sites over time. Error bars denote 95% confidence intervals for proportions based on the binomial distribution.

Fig 3

Patient satisfaction raw scores (a) and percentile rankings (b) benchmarked on 1028 centers nationally.

Fig 3

Patient satisfaction raw scores (a) and percentile rankings (b) benchmarked on 1028 centers nationally.

Fig 4

Total quarterly volume of outpatient MRIs within the entire hospital system. Opening of a new MRI facility within the hospital system and a new MRI facility at a local competitor occurred in Q3 FY15.

Fig 5

Within-system outpatient MRI volumes during the study period. Sites A, B, and C are based in the main hospital complex. A is the newly added site at the Cancer Center. The teams at the hospital-based site C and the outpatient imaging center site D had previously undergone team training.