MRI Safety Return On Ivestment:
Low-Cost, High-Return Suite Audits.

Tobias Gilk

Most MRI facilities are well aware of the operational aspects of MR safety that pertain to clinical practice and patient care activities. Filling out a longer screening form, keeping techs current on their C.E.'s, these help address safety issues, and do so without additional costs. But for some, when it comes to investing in MR Safe equipment, access controls, or changing rooms to gown patients, the MBA-side of the brain takes over. They want to know what 'return on investment' they can expect to see from these investments. Their skeptical nature assumes that money spent on safety would be better piled up and lit on fire, where at least you could roast a marshmallow or two. But there is mounting evidence to support the long-held contention that safety really does pay!

Starting with the most dramatic, the floor-polisher, chair or oxygen tank sucked into the bore, these accidents are quite expensive. Any stuck object requiring a ramp-down is going to have a base price-tag of $20,000 in vendor engineer time. Plus you can probably count on a couple of days of interrupted patient throughput (at around $800 per hour of lost revenue). And if the accident damaged the shroud, table, coils or phantoms, you can start adding repair and replacement costs in $10,000 increments. Repair tabs of over $200,000 for these sorts of accidents are not unheard of.

And if you think that these sorts of accidents are rare or only occur at other facilities, think again. The Canadian Institute for Biodiagnostics has estimated that major missile events (those that should involve a vendor ramp-down) occur at a rate of once every 3 to 5 years. Keith Kopp of Kopp Development, extrapolating the accident data from published reports, has a slightly more conservative estimate of one accident every 6 years.

If an MRI is expected to have a functional life of ten years, this means that, on average, every MRI will experience between one and three of these accidents. Assuming two major incidents with no equipment damage, this represents a minimum total cost to the facility of $70,000. Throw in equipment damage or the injury of a patient or staff member, and the costs of two accidents could begin to rival the cost of the MRI! But the value of safety prevention doesn't hinge on these sorts of headline-grabbing accidents to be demonstrated. There's also money to be made in rudimentary, day-to-day operations.

At a recent real-world test of the efficacy of the new ferrous detection systems, the test hospital found that roughly half of the patients who had successfully cleared the standard screening process would have entered the magnet suite with ferrous materials. Of those carrying ferrous materials, half were found to have ferrous trim on their clothing or other secured objects that didn't represent a missile threat. The other half were carrying phones, pagers, keys and other assorted loose objects that had the potential of becoming airborne. Even if not one of these objects ever flew, the fact that this many ferrous objects would have made it into the magnet room suggests that there would likely have been a number of re-screen and re-scan episodes. For a service that depends upon throughput for its profitability, delays in scanning a patient equal lost revenue.

The drips and drabs of lost throughput collect over the course of a year and can result in tens of thousands of dollars annually in lost revenue. Just obtaining one additional $600 scan per week from efficiency improvements results in over $30,000 additional annual revenue per magnet.

But the tremendous gains that can be found from safety and efficiency improvements don't happen by happenstance, they require a careful analysis of MRI equipment, suite layout and operations. Hospital and imaging faculties can undertake these facility evaluations by pooling the knowledge of the MRI technologists and facility design and construction staff. With resources like the ACR White Paper on MR Safety, MRI vendor mauals, and the latest information on FDA safety alerts and suite design, this team can evaluate a facility and make recommendations to reduce the likelihood of accidents and improve patient throughput. Of course, it isn't necessary to reinvent the wheel.

For a fee of less than $10,000, facilities can obtain a professional suite audit that addresses suite safety and operational issues that directly impact profitability. This audit will inform a facility about ways to improve safety and throughput. And incresed throughput means increased revenue. At $600 per scan, it only takes 17 additional scans to reach payback, for a single magnet that's only additional scan every three weeks to achieve a one year payback.

So safety, when approached systematically, has a significant return on investment. By enhancing safety, a facility can improve the capacity for both patient care and profitability.

To learn more about how MRI safety can improve a facility's profitability, contact Junk Architects at (816) 472-7722.