Optimizing efficiency in CT services: a data-driven approach using action logs from the radiology information system

PURPOSE: To evaluate whether Radiology Information System (RIS) action log-guided continuous quality improvement (KAIZEN) improved CT operational efficiency. MATERIALS AND METHODS: This single-center retrospective before-and-after quality improvement study included 150,540 weekday CT examinations from 2018 to 2022. Five workflow interventions were introduced sequentially from January through February 2021. Daily median examination time, daily median patient entry/exit time, and the end time of the final weekday CT examination were analyzed using segmented interrupted time-series regression with interruptions in January 2020 and January 2021 and heteroskedasticity- and autocorrelation-consistent standard errors. Key performance indicator (KPI) models were adjusted for daily volume, day of the week, and inpatient proportion; unadjusted models were used as sensitivity analyses. RESULTS: Daily median examination time decreased from 351 s at baseline to 328 s after KAIZEN. KAIZEN initiation was associated with an immediate reduction in adjusted examination time (- 17.37 s; 95% CI, - 31.35 to - 3.40 s; p = 0.015), whereas the unadjusted sensitivity analysis was directionally consistent but non-significant (- 11.07 s; p = 0.060). Entry/exit time decreased from 216 to 198 s and showed a significant adjusted immediate reduction (- 15.99 s; 95% CI, - 23.93 to - 8.04 s; p < 0.001), consistent with the unadjusted analysis. The final weekday CT examination ended 12.49 min earlier (95% CI, - 22.11 to - 2.87 min; p = 0.011). CONCLUSION: RIS action log-guided KAIZEN was temporally associated with shorter turnover, earlier completion of weekday operations, and reduced adjusted examination time. Replication in diverse settings is warranted. Secondary Abstract. In this single-center study, RIS action log-guided KAIZEN was temporally associated with shorter CT patient entry/exit time, earlier weekday completion, and reduced adjusted examination time, supporting routine log-based workflow monitoring.