Neurological Institute Outcomes

The Center for Neuroimaging is responsible for the interpretation of brain attack head CTs and CT angiography for the entire Cleveland Clinic health system. Guidelines for Primary and Comprehensive Stroke Centers dictate that a noncontrast head CT should be performed within 20 minutes of presentation and an interpretation should be provided to the responsible licensed independent practitioner within 45 minutes of presentation or within 20 minutes of the acquisition. The graph demonstrates consistent rapid turnaround of reports despite progressive increase in volumes during the past 5 years.

The overall mean for the Cleveland Clinic during 2022 across 22 hospitals with over 5000 exams was 7.78 minutes. N = the overall number of brain attack head CTs performed for acute stroke. Compliance for relaying the interpretation of brain attack scans to the responsible licensed independent practitioner within 45 minutes of presentation or within 20 minutes of acquisition was 96%.

The reporting of emergency room and STAT imaging studies is assigned a higher priority than routine inpatient and outpatient studies in the Center for Neuroimaging. Currently, median turnaround times indicate that emergency and STAT reports are generally completed in < 20 minutes, inpatient reports in < 30 minutes, and outpatient reports in < 1 hour.

The overall median turnaround times for outpatient and inpatient studies during 2022 were < 60 and < 30 minutes, respectively, while the median times for emergency room and STAT studies were ≤ 20 minutes. These times were all well within the targeted turnaround times, regardless of the time of day or day of the week.

While emergency room and STAT studies are assigned a higher priority, all outpatient reports are now generally available within 4 hours during all 3 shifts. The higher median for outpatients during shift 2 is somewhat longer as routine studies performed during the evening may be dictated first thing in the morning to accommodate the increasing demand and acuity of emergency and inpatient studies during the evening.

The jump in turnaround time for 3rd shift in 2021 and 2022 is due to the increased number of outside hospital MRI and CAT scans, which are added to the PACS system for interpretation and timestamped at 12:00 am.

Median turnaround time for inpatient studies have otherwise remained < 45 minutes during the past 5 years for all 3 shifts despite rising volumes. Even with the increases in the 3rd shift times, the turnaround times remain well below the Neurological Institute's goal of 6 hours.

Emergency room and STAT studies are assigned highest priority and the graph demonstrates turnaround times that are substantially below the institutional and national guidelines of 30 minutes. The increase in turnaround times in 2019 is due to changes in the methodology of calculation adopted starting in 2019.

Before 2019 median turnaround times were calculated using the time when a draft or preliminary report was first reported in relation to the time of exam completion. Starting in 2019 median turnaround times were calculated using the time when the attending neuroradiologist signed off on the final report in relation to the time of exam completion.