Imaging Stewardship : Triage for Neuroradiology MR During Limited-Resource Hours
Copyright © 2023 American College of Radiology. Published by Elsevier Inc. All rights reserved..
OBJECTIVES: To decrease call burden on pediatric neuroradiologists, we developed guidelines for appropriate use of MR overnight. These guidelines were implemented using triage by in-house generalist pediatric radiologists. Process measures and balancing measures were assessed during implementation.
METHODS: For this improvement project, interdepartmental consensus guidelines were developed using exploratory mixed-methods design. Implementation of triage used plan-do-study-act cycles. Process measures included reduction in the number of telephone calls, frequency of calls, triage decisions, and number and type of examinations ordered. Balancing measures included burden of time and effort to the generalist radiologists. Differences in examination orders between implementation intervals was assessed using Kruskal-Wallis, with significance at P < .05.
RESULTS: Consensus defined MR requests as "do," "defer," or "divert" (to CT). Guidelines decreased neuroradiologist calls 74% while adding minimal burden to the generalist radiologists. Most nights had zero or one triage request and the most common triage decision was "do," and the most common examination was routine brain MR. Number of MR ordered and completed overnight did not significantly change with triage.
DISCUSSION: Multidisciplinary consensus for use of pediatric neurological MR during limited resource hours overnight is an example of imaging stewardship that decreased the burden of calls and burnout for neuroradiologists while maintaining a comparable level of service to the ordering clinicians.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
|---|---|
| Enthalten in: |
Journal of the American College of Radiology : JACR - 21(2024), 1 vom: 31. Jan., Seite 70-80 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Lopez-Rippe, Julian [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Consensus guidelines |
|---|
| Anmerkungen: |
Date Completed 29.01.2024 Date Revised 29.01.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jacr.2023.10.010 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM363554963 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM363554963 | ||
| 003 | DE-627 | ||
| 005 | 20240129231917.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jacr.2023.10.010 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1274.xml |
| 035 | |a (DE-627)NLM363554963 | ||
| 035 | |a (NLM)37863151 | ||
| 035 | |a (PII)S1546-1440(23)00777-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Lopez-Rippe, Julian |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Imaging Stewardship |b Triage for Neuroradiology MR During Limited-Resource Hours |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.01.2024 | ||
| 500 | |a Date Revised 29.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 American College of Radiology. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: To decrease call burden on pediatric neuroradiologists, we developed guidelines for appropriate use of MR overnight. These guidelines were implemented using triage by in-house generalist pediatric radiologists. Process measures and balancing measures were assessed during implementation | ||
| 520 | |a METHODS: For this improvement project, interdepartmental consensus guidelines were developed using exploratory mixed-methods design. Implementation of triage used plan-do-study-act cycles. Process measures included reduction in the number of telephone calls, frequency of calls, triage decisions, and number and type of examinations ordered. Balancing measures included burden of time and effort to the generalist radiologists. Differences in examination orders between implementation intervals was assessed using Kruskal-Wallis, with significance at P < .05 | ||
| 520 | |a RESULTS: Consensus defined MR requests as "do," "defer," or "divert" (to CT). Guidelines decreased neuroradiologist calls 74% while adding minimal burden to the generalist radiologists. Most nights had zero or one triage request and the most common triage decision was "do," and the most common examination was routine brain MR. Number of MR ordered and completed overnight did not significantly change with triage | ||
| 520 | |a DISCUSSION: Multidisciplinary consensus for use of pediatric neurological MR during limited resource hours overnight is an example of imaging stewardship that decreased the burden of calls and burnout for neuroradiologists while maintaining a comparable level of service to the ordering clinicians | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Consensus guidelines | |
| 650 | 4 | |a MRI | |
| 650 | 4 | |a imaging stewardship | |
| 650 | 4 | |a overnight triage | |
| 650 | 4 | |a pediatric neuroradiology | |
| 700 | 1 | |a Schwartz, Erin S |e verfasserin |4 aut | |
| 700 | 1 | |a Davis, J Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Dennis, Rebecca A |e verfasserin |4 aut | |
| 700 | 1 | |a Francavilla, Michael L |e verfasserin |4 aut | |
| 700 | 1 | |a Jalloul, Mohammad |e verfasserin |4 aut | |
| 700 | 1 | |a Kaplan, Summer L |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of the American College of Radiology : JACR |d 2004 |g 21(2024), 1 vom: 31. Jan., Seite 70-80 |w (DE-627)NLM167902083 |x 1558-349X |7 nnns |
| 773 | 1 | 8 | |g volume:21 |g year:2024 |g number:1 |g day:31 |g month:01 |g pages:70-80 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jacr.2023.10.010 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 21 |j 2024 |e 1 |b 31 |c 01 |h 70-80 | ||