[AVBC 2025] Addressing Ultrasound Scan Postponements: A Quality Improvement Initiative
Care Process & Redesign
Appropriate & Value-based Care Conference
National Healthcare Group
21 November 2025
The aim of this project is to eliminate the postponement of Ultrasound (US) scans due to patients not fasting prior to their. Valuable friendships were forged with different stakeholders to understand the workflows and processes.
Year Submitted: 2025
Published Date: 21 November 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Productivity, Cost Saving
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, the aim is 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 methodology involved identifying root causes for non-compliance with fasting requirements and implementing interventions such as including fasting instructions in SMS reminders and confirmation messages, and providing fasting information sheets to patients.
Results
The number of patients not fasted 6 hours prior to scan decreased significantly post-intervention. The number of postponements reduced from 69 to 13, reschedules to another day from 42 to 7, and patients waiting till later in the day to be re-scanned from 27 to 6. This resulted in 35 new free slots, equivalent to a cost saving of $8,050.
Lessons Learnt
Valuable friendships were forged with different stakeholders to understand the workflows and processes. Effective communication between radiology and clinic 4B was crucial for the project's success.
Keywords
Ultrasound, Fasting, Clinic 4B, Radiography, Gastroenterology
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Diagnostic Radiography, Gastroenterology |
Project Lead(s) | Angelo Aaron Garcia |
Project Member(s) | Teng Wei Peng |
Connect with this contributor!
Angelo Aaron Garcia - angelo.aaron.garcia@nhghealth.com.sg
Project Attachment
919_TTSH_AVBC_2025_Addressing_Ultrasound_Scan_Postponements_A_Quality_Improvement_Initiative.pdf