An electronic chat tool cut phone calls to the duty radiologist by more than half

Design

Retrospective pre- and post-intervention study, 20 matched weekdays each

Population

One tertiary academic radiology department; calls to the duty radiologist

Primary outcome

In-hours telephone calls per weekday to the duty radiologist

Effect

Median 181 to 82 calls a day; workload-adjusted rate ratio 0.56 (95% CI 0.53 to 0.59)

A tertiary radiology department introduced an EMR-integrated chat function with targeted education. Researchers compared 20 matched weekdays before and after, in a retrospective pre- and post-intervention design.

Median in-hours phone calls to the duty radiologist fell from 181 to 82 a day. Total communication events, calls plus messages, fell from 181 to 104. The number of studies protocolled was unchanged (92 vs 97 per day). Communication events per 100 protocolled studies fell from 205 to 114 (rate ratio 0.56, 95% CI 0.53 to 0.59). Median time to read a message was 8 minutes and to reply 14 minutes.

For referring clinicians, the change is that routine questions go through chat and replies may take minutes, not seconds. Urgent matters still need a call. The study cannot show effects on diagnostic quality or satisfaction.

• Route non-urgent protocol and booking questions through chat where available.
• Keep a telephone route for urgent clinical questions.
• Expect replies in minutes, as the median reply was 14 minutes.
• Audit calls before and after any new communication tool.

Why it matters

Interruptions are a hidden cost in busy reading rooms and a plausible source of errors.

Don't overread it

A single department, retrospective, 20-day windows; it did not measure error rates or referrer satisfaction.

The statistics, in plain English

Comparing 20 days before with 20 days after cannot separate the tool from other changes in time. The rate ratio of 0.56 adjusts for workload, but not for seasonal or staffing differences.

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