Sorry, You’ve Got the Wrong Number

How many times have you been deep in thought, trying to interpret a particularly complex case only to have your concentration broken by a phone call? Feeling your train of thought derail is bad enough – having the interruption be intended for a different sub-specialist can make it worse.

This is an all-too-common problem for radiologists, and it is one that investigators from the Icahn School of Medicine at Mount Sinai Hospital in New York set out to solve. After surveying radiology residents – those providers who are most likely to to take the calls made to the radiology department – and emergency department physicians, the team, led by Nicholas Voutsinas, M.D., chief resident of diagnostic and interventional radiology at Ichan, developed a web-based tool to limit those wrong numbers and correctly route inquiries.

“At our hospital, we anecdotally noted that a significant portion of incoming phone calls were misdirected to the wrong workstation,” the team said. “This resulted in wasted time, unnecessary interruptions, and delays in care because the referring clinicians could not efficiently navigate the radiology department staffing structure.”

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In an article published in the May/June issue of Current Problems in Diagnostic Radiology, the team described the frequency of this problem and how they improved it.

Based on a survey of radiology residents and emergency department physicians conducted between Aug. 1, 2017, and Sept. 15, 2017, the team determined misdirected phone calls were a pervasive problem. Of the responding radiology residents (27 individuals), 74 percent said they received at least two wrong numbers daily, and 57.9 percent of emergency department providers (38 respondents) indicated they reached the wrong radiology workstation at least once a day.

Residents reported the most incorrect phone calls were intended for the emergency department plain film and the body CT stations. Emergency providers indicated they most commonly sought out the body CT, neuroradiology, and ultrasound stations.

The solution was simple, Voutsinas’s team said. They created an easily accessible web-based tool that can be quickly updated in real-time with correct contact numbers for pertinent reading room stations, all scheduling desks, and all technologist workstations. It includes both weekday and weekend schedules and does not include the general radiologist-on-call pager number. This interactive tool is available on the emergency department intranet to facilitate ease-of-use.

Eight months after implementing the contact sheet, the team repeated the survey, and the improvement was noticeable, they said. The number of radiology residents receiving at least two misdirected calls daily had dropped to 58.4 percent with 50 percent believing that wrong numbers from the emergency department, specifically, had decreased.

In addition, 82.1 percent of emergency department physicians reported using the web-based contact sheet. Only 17.9 percent of these provides said they still had at least one misdirected call daily, and further evaluation revealed these individuals were unaware of the contact sheet altogether.

The survey results also showed that this provider group had an improved understanding of radiology workflow, the team said, and the contact tool had increased dialogue between the two groups on how to augment their working relationship.

“By educating the [emergency department] providers’ behavior, we believe we reduced the burden on [the] resident while shortening the latency for contacting the correct recipient,” the team concluded. “Given the overall positive success of this project, it is possible a similar solution could be employed throughout the hospital."

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