Addressing Ultrasound Scan Postponements: A Quality Improvement Initiative
Care Process & Redesign
National Healthcare Group Quality Improvement
National Healthcare Group
24 December 2025
The aim of this project is to eliminate the postponement of Ultrasound (US) scans due to patients not fasting prior to their. The interventions successfully reduced the number of non-fasted patients and improved the scheduling process, leading to significant.
Year Submitted: 2025
Published Date: 24 December 2025
Tags: Care Process ＆ Redesign, Workflow Redesign, Cost Saving, Time Saving, Quality Improvement, Productivity, Operational Management, Scheduling ＆ Planning
About this Content
Aims
The aim of this project is to eliminate the postponement of Ultrasound (US) scans due to patients not fasting prior to their US scan in Clinic 4B. Therefore, we aim to ensure that there are zero patients not fasted prior to their ultrasound scans in 6 months.
Background
Clinic 4B has been identified as the primary source of non-fasted patients requiring ultrasound scans. Among its various specialty departments, Gastroenterology (GE) and Hepatology generate the highest volume of ultrasound orders. Ultrasound scans are essential diagnostic tools in GE practice, regularly used to evaluate both acute and chronic abdominal conditions. According to work instruction WI-DIR-DOC-002, patients must observe a mandatory six-hour fasting period before abdominal ultrasound scans to ensure clear gallbladder visibility. Clinic 4B alone records an average of 52 postponed ultrasound appointments monthly due to patients failing to meet fasting requirements.
Methods
The project involved several interventions: including a line in SMS reminders to fast 6 hours prior to scans, editing the reminder template at EMS, including fasting instructions in confirmation SMS, and creating a simple patient info sheet on fasting. Strategies to sustain the improvements included continuous communication, regular evaluation, and random audits.
Results
The number of postponements reduced from 69 to 13, and patient reschedules to another day reduced from 42 to 7. The equivalent cost saving from freeing up slots was $8,050.
Conclusion
The interventions successfully reduced the number of non-fasted patients and improved the scheduling process, leading to significant cost savings.
Lessons Learnt
Valuable friendships were forged with different stakeholders to understand workflows and processes. Effective communication between radiology and Clinic 4B was crucial for the project's success.
Keywords
Ultrasound, Fasting, Radiography, Clinic 4B, Quality Improvement
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | National Healthcare Group Quality Improvement |
Healthcare Professional Group(s) | Allied Health |
Applicable Specialty or Discipline | Diagnostic Radiography |
Project Lead(s) | Angelo Aaron Garcia, Teng Wei Peng |
Project Member(s) | Huang Zhiyan |
Connect with this contributor!
Group Quality - nhggroup.QRM@nhghealth.com.sg
Project Attachment
956_TTSH_2025_QI_Award_Addressing_Ultrasound_Scan_Postponements_A_Quality_Improvement_Initiative.pdf