Journal of Ultrasound in Medicine, Vol 20, Issue 9 973-978, Copyright © 2001 by American Institute of Ultrasound in Medicine
A pilot study of time allocation and reimbursement for routine obstetric ultrasonography
K. S. Stewart, M. C. Treadwell and I. E. Zador
Department of Obstetrics and Gynecology, Hutzel Hospital, Wayne State University, Detroit, Michigan 48201, USA.
OBJECTIVE: To evaluate time allocation during initial and repeated
ultrasonography and to formulate recommendations to improve unit
efficiency. METHODS: Over a 2-year period, 51 comprehensive
ultrasonographic examinations between 14 and 38 weeks' gestational age were
observed by a single reviewer. Each patient-sonographer interaction was
divided into timed segments, including setup, examination time, review, and
turnover. Statistical analysis using descriptive statistics, Student ttest,
and analysis of variance was performed to determine the effect of the
number of ultrasonographic examinations, sonographer experience, estimated
gestational age, and patient body mass index on examination time. RESULTS:
The average time spent with each patient was 15 minutes 22 seconds: 2
minutes 10 seconds for setup, 9 minutes 38 seconds for examination, 1
minute 50 seconds for review, and 1 minute 44 seconds for turnover.
Examination length was not significantly affected by estimated gestational
age, body mass index, ultrasonography experience, or the number of
ultrasonographic examinations (P > .05). No statistical significance in
the duration of scanning was found between initial (15 minutes 3 seconds)
and repeated (16 minutes 1 second) examinations (P = .609). Nonexamination
activities, such as data entry and room cleanup, consumed 37% of the
sonographer's time. CONCLUSIONS: Resource use within the ultrasonography
department may be improved by reassigning clerical and custodial duties
from sonographers to other personnel. Although differential reimbursement
exists, no statistically significant difference in resource use between
initial and repeated examinations was found.
