610 - First Case, Best Case: Unlocking Efficiency in Interventional Radiology

Purpose: Delays in first case start (FCS) times in hospital-based interventional radiology (IR) departments contribute to procedural backlogs, increased staff overtime, and reduced patient and provider satisfaction. Improving FCS is a recognized operational priority in IR workflow optimization.

Materials and Methods: A prospective quality improvement study was conducted in a tertiary-care academic IR department over 12 months. Baseline metrics were collected for 3 months, including the proportion of on-time FCS (patient entry within 15 minutes of scheduled start). A multidisciplinary intervention was implemented: standardized patient arrival times, a pre-procedure nursing checklist, daily morning huddles, and real-time case tracking. Primary outcomes were on-time FCS rate, daily case volume, room turnover time, and staff overtime hours. Statistical analysis used chi-square and paired t-tests (significance: p < 0.05).

Results: On-time FCS increased from 41% to 78% post-intervention (p < 0.001). Mean daily case volume rose from 7 to 8 cases per IR suite (12% increase). Room turnover time improved by 10 minutes (p = 0.02), and staff overtime hours decreased by 21%. Root cause analysis revealed delays from incomplete labs and late arrivals. Staff reported improved communication and morale.

Conclusion: A structured, multidisciplinary quality improvement initiative significantly improved first case start times, procedural throughput, and staff efficiency in a hospital-based IR department. These findings support the adoption of standardized workflow interventions to enhance operational performance in IR practice.