Radiologist report turnaround time: impact of pay-for-performance measures

AJR Am J Roentgenol. 2010 Sep;195(3):707-11. doi: 10.2214/AJR.09.4164.


Objective: Expedited finalized radiologist report turnaround times (RTAT) are considered an important quality care metric in medicine. This study was performed to evaluate the impact of a radiologist pay-for-performance (PFP) program on reducing RTAT.

Materials and methods: A radiologist PFP program was used to assess its impact on RTAT for all departmental reports from 11 subspecialty divisions. Study periods were 3 months before (baseline period) and immediately after (immediate period) the introduction of the program and 2 years later after the program had terminated (post period). Three RTAT components were evaluated for individual radiologists and for each radiology division: examination completion (C) to final signature (F), C to preliminary signature (P), and P to F.

Results: Eighty-one radiologists met the inclusion criterion for the study and performed a final signature on 99,959 reports during the baseline period, 104,673 reports during the immediate period, and 91,379 reports during the post period. Mean C-F, C-P, and P-F for all reports decreased significantly from baseline to immediate to post period (p < 0.0001), with the largest effect on the P-F component. Similarly, divisional C-F, C-P, and P-F also significantly decreased (p < 0.0001) for all divisions except the C-F for nuclear and neurovascular radiology from baseline to immediate period and the C-P component from baseline to post period for cardiac radiology.

Conclusion: A radiologist PFP program appears to have a marked effect on expediting final report turnaround times, which continues after its termination.

MeSH terms

  • Algorithms
  • Analysis of Variance
  • Documentation / standards
  • Efficiency, Organizational
  • Forms and Records Control / organization & administration*
  • Humans
  • Medical Records / standards*
  • Radiology Department, Hospital / economics*
  • Radiology Department, Hospital / standards
  • Radiology Information Systems
  • Reimbursement, Incentive*
  • Statistics, Nonparametric
  • Time and Motion Studies*
  • Total Quality Management