What is report turnaround time, and why does the headline number mislead?
Report turnaround time is the metric every radiology operation reports and the one most likely to be measured in a way that conceals the problem.
Two things go wrong with it.
Turnaround gets blended. One average across all modalities, priorities and sites produces a number that moves slowly and explains nothing. Split it: by modality, by priority, and by referring site. The variation between those slices is the finding, not the average across them.
Turnaround gets measured on the wrong clock. Most systems measure study complete to report signed, because that is the interval the reading system can see. The referring office measures something else entirely: study complete to report in my hands. If those two numbers differ materially, the gap is in distribution, and no amount of reading-room optimization will close it.
What else should you measure?
Turnaround is not the only one, and the rest are usually available from the same timestamps:
Throughput per modality per hour, which shows where capacity actually sits
Utilization per room, not per site, because site-level figures conceal an idle scanner next to a saturated one
Wait time from arrival to acquisition, which is what the patient experiences and no clinical metric captures
No-show and cancellation rate by slot type, which tells you whether the problem is the schedule or the reminder
Time from a critical finding to acknowledged receipt, which is a safety measure before it is an efficiency one
Why are critical findings a workflow obligation, not just good practice
The last one deserves separating out. When a study shows something urgent, the communication is a professional obligation with a documentation requirement attached, not a courtesy call.
The ACR practice parameters address this directly. In emergent or other non-routine situations, the interpreting physician should expedite delivery of the report so that timely receipt is reasonably ensured. Non-routine communications should be documented, in the report or the patient's medical record.
The parameter has a concrete workflow consequence. If your process for an urgent finding is a phone call that somebody remembers to log afterwards, the documentation depends on memory. The workflow question is whether the acknowledgement is captured as part of the communication rather than after it.
