A picture archival and communication system shortens delays in obtaining radiographic information in a medical intensive care unit

Objective: To assess whether variables such as unit occupancy and aggregate severity of illness that reflect increased work demands on physicians in m edical intensive care units (MICU) are associated with increased delays in their obtaining information about nonroutine chest radiographic examination s. To determine whether the presence of a picture archiving and communicati on system (PACS) workstation in the MICU shortens those delays. Design: A prospective cohort study stratified for presence or absence of PA CS. Setting: MICU of a university hospital. Patients: A total of 118 patients admitted to the MICU who had nonroutine b edside chest radiographs. Measurements and Main Results: Multivariate analyses were conducted to dete rmine how unit occupancy, patient acuity, the time of day the examination w as taken, and the presence of a PACS workstation influenced the time from r adiographic examination completion to the time when MICU physicians first o btained image information. In a multivariate analysis, patient acuity, unit occupancy, the aggregate l ever of severity of illness in the study cohort, whether the examination wa s taken at night or day, and the presence of a PACS workstation were signif icant predictors of the elapsed time from examination completion until revi ew by MICU physicians. Without the PACS workstation, higher occupancy, high er aggregate severity of illness, and examinations taken during the day wer e associated with longer delays. Overall, the multivariate analysis showed a 24-min decrease in the elapsed time to obtain information during periods with the FAGS workstation compared with periods without the workstation (p =.03). Conclusions: A PACS workstation significantly decreased the delays in obtai ning image information that occurred with high unit occupancy and high aggr egate severity of illness and may improve unit efficiency under conditions of high physician workload.