Impact of a dedicated consult shift on reducing time to resolution of diagnostic disagreements: A quality improvement initiative

BACKGROUND Delays in resolving diagnostic disagreements within the quantitative imaging analysis core can impede clinical workflow and compromise patient care. To address this, a dedicated consult shift was initiated in 2023. This intervention included real-time monitoring through a dashboard overseen by an imaging specialist who alerted the designated consultant for immediate evaluation and resolution. AIM To evaluate the impact of a dedicated consult shift on diagnostic disagreement resolution times and operational efficiency. METHODS This retrospective quality improvement study analyzed timestamp data from 1245 cases of diagnostic disagreement spanning the period from 2017 to 2025. Cases were stratified into two groups: Pre-implementation (2017-2022) and post-implementation (2023-2025). The primary metric was time to resolution in days. Both means and medians were compared using an independent samples t -test and a Mann-Whitney U test, respectively. RESULTS The average time to resolution significantly decreased from 100.58 days (2017-2022) to 33.05 days (2023-2025) (t = 10.02, P < 0.0001). Additionally, the median time to resolution dropped from 20.90 days to 5.02 days, a statistically significant reduction confirmed by the Mann-Whitney U test (U = 241577, P < 0.0001). CONCLUSION The introduction of a dedicated consult shift, supported by real-time dashboard tracking, led to a significant improvement in both average and median resolution times for diagnostic disagreements. This intervention optimized the workflow and reinforced quality assurance processes in a clinical trial imaging setting.