Addressing Capacity Challenges in the MRI Department

Kellie Cahill, operations manager, and Erin Desmond, technical supervisor, both of the MRI Department in Radiology, speak about their roles and how the team works closely with the MGH Capacity Coordination Center to coordinate inpatient MRIs and helps to ease capacity challenges at Mass General.

Q: What does a typical day look like for each of you?

Kellie: On a typical Monday morning, a report of pending inpatient MRI orders is reviewed with radiologists from Gastroenterology, Musculoskeletal and Neurology divisions, along with a member of the Capacity Coordination team. Together, we review and triage cases according to impacts to patients’ progress of care or their discharge planning from Mass General. Sometimes, we determine that an MRI wouldn’t be appropriate for a particular patient based on clinical indications or a patient’s clinical status. That’s when the division radiologist calls their responding clinician to discuss alternatives.

Erin: If it is determined the MRI is a high priority or critical to the patients progress of care, we work to coordinate for the exam within the clinically appropriate timeframe discussed during the Capacity Call. During the daytime, I watch the different MRI resources that may have procedural cases already booked and look for opportunities to work the triaged inpatients into the schedule.

Q: How does this work help ease capacity challenges at MGH?

Kellie: If a patient is clinically appropriate to go home but still needs the MRI, we’ll work to schedule an expedited outpatient appointment at one of our MGB locations. This allows the patient to get home and opens up a much-needed bed. Any time we’re able to get a patient home sooner and still provide their imaging needs, it’s a win for all.

Erin: We work closely with the Capacity team throughout the week as cases are brought to their attention. The Capacity team really understands some of the challenges we face when it comes to getting patients’ exams scheduled in a timely manner and is able to help relay this to care team so that barriers can be addressed on the floor. It’s critical that we always emphasize to patient care teams the importance of being ready to travel when the MRI slot is available.

Q: What are some of the common challenges you face when scheduling MRIs?

Kellie: There are many reasons why a patient’s MRI might not go as planned. Some patients have complicated implants and devices such as pacemakers, and others need additional resources such as anesthesia to tolerate the MRI. We don’t always have those resources at our disposal, so it increases the time it takes to get that study scheduled.

Q: What’s the most rewarding part of this work?

Erin: Sometimes, during our Monday meetings, we have upwards of 50 pending inpatient MRI orders to review. So, when I’m able to send my midday summary and see that we were able to overturn half of those cases by completing MRIs, canceling unnecessary exams or expediting outpatient appointments, it’s really rewarding.

Kellie: We really appreciate knowing that the patients we’re moving through the department on a more urgent timetable are the ones who need it the most. It’s great that we can work with the Capacity team and have physicians weigh in on MRI scheduling – our queue can get very long and working together allows us to plan strategically and set expectations for the team and the department.

Q: How does working together with the Capacity team improve outcomes for your patients?

Kellie: We’ve really appreciated the opportunity to share more about the complexities of MRIs. The MRI environment is extremely dangerous and requires extensive screening of patients in advance of their exam to be sure they can be safely imaged. If we encounter a barrier to imaging a patient through our screening process, the Capacity team can communicate to the clinical team best next steps to complete the MRI successfully.

Erin: Working with physicians who understand some of the barriers we face has been great. A patient may have an undocumented implant, needs medication to tolerate the MRI, or may not want to travel to MRI, and this often causes delays in getting the MRI done. The Capacity team is able to vocalize at the physician level how these barriers are impacting a patient’s ability to get the MRI. Once these barriers are addressed, MRI will continue to do everything we can to get the patient imaged successfully – which then helps patient get the care they need.