Can you please hold? An assessment of the impact of reporting room assistants on interruptions in the reporting room of a major trauma tertiary center.

BACKGROUND

Radiology departments provide imaging support for emergency, inpatient and elective care, with radiologists responsible for image interpretation, scan vetting, protocoling, advising clinical teams, and communicating urgent findings. In major trauma centers, urgent Computed Tomography (CT) examinations are interpreted during "hot reporting," where radiologists provide real-time reports to guide immediate clinical decision-making. These sessions are high-pressure, high-volume environments and frequently interrupted by telephone calls and in-person queries. Such interruptions disrupt cognitive workflow, delay reporting and communication of urgent findings, contribute to reporting errors and may affect patient safety. Centers in the USA, Australia, and Europe have introduced Reporting Room Assistants (RRAs)-typically medical students or administrative staff, and less frequently radiology residents or radiographers-to manage interruptions, but their effectiveness has not been evaluated in UK hospitals.

METHODS

This prospective single-center pre-post intervention study was conducted in a radiology department of a UK major trauma tertiary center. Interruptions in the reporting room were assessed over five weekdays before (April 2022) and 6 months after (October 2022) introducing two RRAs. Standardized data collection forms recorded the nature, number, and impact of interruptions. Radiologists' perceptions of interruptions were assessed with questionnaires.

RESULTS

Telephone calls were the main source of interruptions pre- and post-intervention (82%, n = 234 vs. 95%, n = 249). The mean daily number of interruptions was similar pre- and post-intervention (57 SD 9.4 vs. 52 SD 8.3; P = .84). The mean duration per interruption significantly reduced post-intervention (2 min 15 s vs. 1 min 41 s; P < .001). All pre-intervention interruptions disrupted radiologist workflow. RRAs triaged all post-intervention interruptions, with 76% having no immediate impact on reporters (P < .001). Interruptions causing loss of train of thought fell by 90% (P < .001) and those leading to report closure by 63% (P < .001). In-person interruptions decreased from 18% (n = 50) to 5% (n = 13, P < .0001). Radiologists reported improved workload manageability and a better working environment post-intervention.

CONCLUSION

This is the first UK major trauma center study demonstrating that RRAs significantly reduced the number and disruptive impact of interruptions to radiologists' workflow during hot reporting. By effectively triaging and managing interruptions, RRAs preserved radiologists' cognitive bandwidth, enabling them to focus on tasks requiring their specialty expertise. Study findings support RRAs as effective strategies to improve workflow efficiency, and although not directly measured, there are potential benefits of RRAs for improving safety and accuracy of reporting amid rising imaging demands. Further work should assess the impact of RRAs on diagnostic accuracy, patient outcomes, and cost-effectiveness.