GRID Exam Search and Turnaround Time

TABLE OF CONTENTS

• Purpose
• How to Access
• Report Dashboards
  • Exam Search Dashboard
  • Turnaround Time Summaries Dashboard
  • Time of Day Histogram
  • Time of Day Scatterplot Dashboard

Purpose

These reports provide an efficient way to identify and further investigate exams with outlier turnaround times and to ensure the accuracy and completeness of data submitted to the registry. Regularly reviewing the data can help you correct data entry or submission problems early on and provide the data your facility submits for quality measure reporting are of high quality.  The report also can help to identify targets for improving a facility's turnaround times and to demonstrate exemplary report turnaround time performance.

How to Access

Log in to the NRDR portal, select GRID under Quality Improvement Registries, and under Interactive Reports, select Exam Search to access the report. Several help features are available:

• The About this Report dashboard provides insight into the report's measures and filter use. 

• The information icons (blue circle) provide details about maximizing the report’s analysis capabilities and report download instructions.

• The Help link opens a text overlay that provides explanations about the report's features

• The Read about this report link opens a browser tab to this Knowledge Base article.

Report Dashboards

Get started by selecting one or more Corporate Accounts, at least one corresponding Facility, and a time frame of interest using the Exam From - To filter.

Exam Search

The report enables you to query exam data for one or more facilities using a variety of filters:

• Modality, Physician NPI, CPT Code, and Study Name: Pinpoint areas to further explore using the filters' criteria.

• Place of Service: Sort performance by Ambulatory, Inpatient, and ED care settings.

• Number of Readers: View the impact on turnaround times of having more than one reader, e.g., a resident and attending physician.

• Sort Exams by: View performance results sorted by date or turnaround time.

• Turnaround (filter): Filter exams by the report turnaround time, in hours. 

• Turnaround time units: Select hours or minutes

The sample report shows performance results for CT abdomen exams submitted in the first half of 2023. The turnaround time sliding filter is set for greater than 1.0 hour. Hover over a value in the Turnaround Time (hrs.) column to see the details of the calculation, including the date the final report was signed.

The turnaround time filter is a useful way to identify exams with unusual values, such as very high turnaround times or negative times. The sample report to the left shows the table sorted by date. Turnaround times, in hours, are displayed both numerically and with a bar to help highlight larger values. The bar is light blue for positive turnaround times and red for negative values.

The report can also help you investigate performance for a specific setting and type of exam, for example showing turnaround times for trauma emergency services.

Turnaround Time Summaries 

This report can help you quickly identify turnaround time performance anomalies or patterns by reviewing data across a variety of variables. The report can also provide insight into the effect of new processes and performance improvement efforts. For example, the report can help you assess the impact of new scheduling methods, changes in staffing levels, and new equipment. Performance trends can be delved into for a specific period for one or more facilities, modalities, and exam types.

The tables display the number of exams and average turnaround time by Facility ID, NPI, Modality, Place of Service, and Number of Readers. 

Rows in each table are sorted by descending average turnaround time. The light gray bars highlight exam volumes and the blue bars indicate turnaround times. All summary tables are interactive; clicking on a row will filter the rest of the report, including the exam table. For example, click on ED in the Place of Service Summary Table as shownin the example below to display data for the ED only in all other tables and charts.

To undo a selection, click it again or click the Undo button in the bottom left corner of the report.

The Sort Exam Table filter sorts the exams by turnaround time or by date.

The heat map calendars display average turnaround times by the date exams are completed and by the date, the corresponding final reports are signed for the time period selected in the Exam From and To filter. Blue denotes dates with average shorter turnaround times and red indicates average longer times. 

The sample report shows how selecting a day in the Data Exam Completed calendar updates the report.

Time of Day Histogram

The Time of Day Histogram charts the median turnaround time (the blue line) for one or more facilities and the number of exams (the grey bars) as selected (or set as the default) in the dashboard's filters, e.g., facility, date range, modality, etc.  The red dotted line shows the median turnaround time for the specific time of day shown on the X-axis for all GRID facilities. The Comparison filter enables the selection of the peer group of interest.

Click a grey bar in the Hour of Day Exam Completed histogram to drill down for turnaround time details by day of the week.  

Click a grey bar in the Day of the Week histogram to view a whisker plot graph that shows all the exams for the selected hour of day and day of the week. The dark grey box is the range between the 25th and 50th percentiles, the light grey box is the 50th to 75th percentiles. The dark horizontal "whiskers," or lines, are 1.5 times the interquartile range, i.e., 1.5 times the range between the 75th and 25th percentiles. The dots outside the whiskers represent outlier exams.  Hovering over a grey bar or a dot in the box plot provides more details as shown in the screenshot below.

Time of Day Scatterplot 

The scatterplot shows how much a facility's turnaround time differes from the selected peer comparison group and can help identify patterns across different sites, modalities, and places of service. Each mark in the plot represents a unique facility, modality, place of service, and time of day. The size of the mark indicates the volume of exams. Hover over a mark to view the details.  The y-axis is the ratio of the facility's median turnaround time to the median of the comparison peer group selected in the filter. The grey line at y=1.0 indicates the point at which the facility's median turnaround time and comparison median turnaround time are the same. Marks below the line indicate better performance compared to the peer group selected and marks above the line indicate worse performance.