Assessing Radiology Workflow Interruptions with Electronic Communications: A Structural Topic Modeling Analysis

Purpose: Interruptions via electronic communication platforms (ECPs) pose a growing threat to patient safety and workflow efficiency in academic radiology. While ECPs like Webex offer benefits, their constant notifications disrupt radiologists and technologists, potentially impacting cognitive processes, increasing workload, and leading to errors.

Methods/Materials: We analyzed Computed Tomography (CT) based Webex communications in the abdominal reading room from a single academic institution to understand the type of conversations that occur through the platform through descriptive statistics and a structural topic modeling (STM) algorithm. STM is a machine learning method for analyzing large collections of text to produce themes and identify how these themes vary based on structural information such as the time of the message. Analysis was performed across 3 timeframes corresponding to changes in radiologist coverage.

Results: We identified 22,446 messages between September 2022 and 2023. The average messages per hour across the three timeframes were: 7:30am-4:30pm: 4.21 (sd = 3.41, min = 1, max = 27); 4:30pm-9pm: 4.16 (sd = 3.48, min = 1, max = 23); and 9pm-7:30am: 3.08 (sd = 2.91, min = 1, max = 28). The most commonly occurring words across the messages are depicted in Figure 1. STM revealed five themes: 1) Communication issues: unclear orders from ordering providers, mainly during 7:30am-9:00pm, 2) Protocol clarifications: based on patient acuity, mainly during 4:30pm-7:30am, 3) Contrast-related questions: allergies and complex cases, during 7:30am-9:00pm, 4) protocol related questions for complex cases, found between 7:30am-4:30pm, and 5) exam completion requests from radiologists concentrated in 4:30pm-7:30am. The themes, their prevalence in percentage, and the associated frequent words are depicted in Figure 2.

Conclusions: These findings highlight the need for targeted interventions to reduce ECP interruptions. Optimizing ECP communication features and tailoring communication protocols based on time of day and message type could mitigate interruptions and improve workflow efficiency, ultimately enhancing patient safety and productivity.