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10 Best Practices for a Great Worklist

Posted on 10/13/15

1. Get the high priority exams covered.Whether you assign dedicated STAT readers or make STAT exams top priority for every shift, make sure all radiologists aware when they need to help out with STAT exams. Create auto-alerts when the STAT list gets long or create a worklist with STAT exams that have less than 10 minutes until SLA expires on top of almost every reader’s worklist.

2. Sort by “Time Remaining to SLA”. Create SLA rules for all exams, even if you’re not contractually obligated to meet them. Use the “Time Remaining” column as your second level sort order after priority. This provides a nearly infinite sort order, ensuring that the next most important exam is read next.

3. Optimize your subspecialty readers, but not at the expense of SLAs. Create subspecialty worklists that span across all your customer sites. Subspecialty readers read from shared worklists sorted by time remaining to ensure SLA’s are best met. Use specific assignments only when requested by a customer. An exam assigned to one radiologist may not be the next exam read by a group of subspecialty readers.

4. Encourage reading in “Auto-Next” mode. The best worklist is the worklist you never look at. If the worklist is built properly, you should not have to go back and look at it every time you want to read the next exam. Just say “Finish and Sign” and the next exam is served up.

5. Index, Index, Index. Defining which exams are MSK could involve searching for multiple procedure name keywords or procedure codes. Do this one time, by tagging the exam. Then, the worklist will be usually updated in about one second.

5. Limit scrolling through a giant worklist. Do this by limiting your page size or by making your worklist more specific to what you are working on. This will increase worklist performance as well.

7. Efficiently close out radiologists requests. Radiologists should use notes to submit an operations request. When notes are added to an exam by a radiologist it triggers different things to happen, depending upon the note. Some notes should remove the exam from the radiologist’s worklist and add them to a radiology assistant’s worklist. Some notes trigger follow-up action immediately (like Critical Findings). Some notes should trigger follow-up action days or weeks after the exam is read.

8. The worklist configuration should support “Burst Reading”. There are occasions when a collection of relatively low RVU exams should be read before a very long and complicated case. This reduces the overall TAT for the exams. When you collect a bunch of exams and “Burst Read” in auto-next, you can significantly improve TATs for your practice.

9. Keep shared as well as personalized worklists. Some worklists are better maintained by the IT group or practice leadership. Some Radiologists (such as the peer review administrator or researchers) will need to store and maintain their own worklists for only their use.

10. Keep worklists for the Operations team. These are worklists used by the operations or practice management team to monitor your practice. Minimally, your operations team should monitor “All Unread” for exams nearing SLA, and “Exams with Open Communications” to monitor radiologists requests. Auto-alerts can also be configured if any of these lists needs attention.