A pilot study of time allocation and reimbursement for routine obstetric ultrasonography

Objective. To evaluate time allocation during initial and repeated ultrason ography and to formulate recommendations to improve unit efficiency. Method s. Over a 2-year period, 51 comprehensive ultrasonographic examinations bet ween 14 and 38 weeks' gestational age were observed by a single reviewer. E ach patient-sonographer interaction was divided into timed segments, includ ing setup, examination time, review, and turnover. Statistical analysis usi ng descriptive statistics, Student t test, and analysis of variance was per formed to determine the effect of the number of ultrasonographic examinatio ns, sonographer experience, estimated gestational age, and patient body mas s index on examination time. Results The average time spent with each patie nt was 15 minutes 22 seconds: 2 minutes 10 seconds for setup, 9 minutes 38 seconds for examination, 1 minute 50 seconds for review, and 1 minute 44 se conds for turnover. Examination length was not significantly affected by es timated gestational age, body mass index, ultrasonography experience, or th e number of ultrasonographic examinations (P > .05). No statistical signifi cance In the duration of scanning was found between initial (15 minutes 3 s econds) and repeated (16 minutes 1 second) examinations (P = .609). Nonexam ination activities, such as data entry and room cleanup, consumed 37% of th e sonographer's time. Conclusions. Resource use within the ultrasonography department may be improved by reassigning clerical and custodial duties fro m sonographers to other personnel. Although differential reimbursement exis ts, no statistically significant difference in resource use between initial and repeated examinations was found.