• R O Redfern, H L Kundel, M Polansky, C P Langlotz, S C Horii, and P N Lanken.
• Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104, USA. redfern@mig.upenn.edu
• Crit. Care Med. 2000 Apr 1;28(4):1006-13.

ObjectiveTo assess whether variables such as unit occupancy and aggregate severity of illness that reflect increased work demands on physicians in medical intensive care units (MICU) are associated with increased delays in their obtaining information about nonroutine chest radiographic examinations. To determine whether the presence of a picture archiving and communication system (PACS) workstation in the MICU shortens those delays.DesignA prospective cohort study stratified for presence or absence of PACS.SettingMICU of a university hospital.PatientsA total of 118 patients admitted to the MICU who had nonroutine bedside chest radiographs.Measurements And Main ResultsMultivariate analyses were conducted to determine how unit occupancy, patient acuity, the time of day the examination was taken, and the presence of a PACS workstation influenced the time from radiographic examination completion to the time when MICU physicians first obtained image information. In a multivariate analysis, patient acuity, unit occupancy, the aggregate level of severity of illness in the study cohort, whether the examination was taken at night or day, and the presence of a PACS workstation were significant predictors of the elapsed time from examination completion until review by MICU physicians. Without the PACS workstation, higher occupancy, higher aggregate severity of illness, and examinations taken during the day were associated with longer delays. Overall, the multivariate analysis showed a 24-min decrease in the elapsed time to obtain information during periods with the PACS workstation compared with periods without the workstation (p = .03).ConclusionsA PACS workstation significantly decreased the delays in obtaining image information that occurred with high unit occupancy and high aggregate severity of illness and may improve unit efficiency under conditions of high physician workload.

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