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Goldman-Yassen AE, Strauss SB, Vlismas PP, Jagannath AD, Yuan M, Farinhas JM, Burns J, Bello JA. Face-to-Face: Resident-led Radiology Medicine Rounds Facilitate Evidence-based Processes for Clinical Decision Support. Curr Probl Diagn Radiol 2021; 50:580-584. [DOI: 10.1067/j.cpradiol.2020.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/09/2020] [Accepted: 05/26/2020] [Indexed: 11/22/2022]
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2
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Reichman M, Arleo EK, Min RJ, Hentel K, Cahill M, Ruddy T, Sullivan D, Drotman M. Adding value in the era of COVID-19: Increasing usage of a patient-centered radiology consultation service. Clin Imaging 2021; 80:211-214. [PMID: 34343836 PMCID: PMC8261130 DOI: 10.1016/j.clinimag.2021.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the effects of COVID-19 pandemic on our department's Radiology Consultation Service (RCS) related to breast imaging, and how utilization of the provided services may have differed as compared to prior to the pandemic. MATERIALS AND METHODS A retrospective cohort study of patients and health care providers who consulted the RCS, as well as those patients who had a screening mammogram and/or ultrasound between January 1, 2019 and September 1, 2020. Consultations were performed by an RRA, RN and one of 17 breast imaging radiologists assigned to consults on daily. Descriptive statistics were performed to describe the study subject population. RESULTS Between January 1, 2020 and July 31, 2020, a total of 1623 consultations were performed, in comparison to the control period from the year prior (January 1, 2019 to July 31, 2019), when a total of 1398 consultations were performed, representing a 16% increase in one year. Between March 1, 2020 and June 30, 2020, a total of 679 consultations were performed, in comparison to the control period from the year prior (March 1, 2019 to June 30, 2019), when 583 consultations were performed, representing a 16.5% increase in a four-month period. 350 out of 679 (36.8%) consultations addressed COVID concerns. CONCLUSIONS While much of radiology experienced an unprecedented decrease in imaging studies during the initial peak of COVID-19 crisis, the RCS at our institution showed a significant increase in services provided, evolving to address pressing concerns related to COVID-19.
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Affiliation(s)
- Melissa Reichman
- Weill Cornell Medical College at New York-Presbyterian Hospital, 425 East 61st Street, 9th Floor, New York, NY 10065, United States of America.
| | - Elizabeth Kagan Arleo
- Weill Cornell Medical College at New York-Presbyterian Hospital, 425 East 61st Street, 9th Floor, New York, NY 10065, United States of America
| | - Robert J Min
- Weill Cornell Medical College, New York Presbyterian Hospital, 525 E. 68th Street Box 141, New York, NY 10065, United States of America
| | - Keith Hentel
- Weill Cornell Medical College, New York Presbyterian Hospital, 525 E. 68th Street Box 141, New York, NY 10065, United States of America
| | - Meghan Cahill
- Radiology Consultation Service, Department of Radiology, Weill Cornell Medical College, 520 E. 70th Street Star Pavilion, New York, NY 10065, United States of America
| | - Tara Ruddy
- Radiology Consultation Service, Department of Radiology, Weill Cornell Medical College, 425 E. 61th Street, New York, NY 10065, United States of America
| | - Deirdre Sullivan
- Radiology Consultation Service, Department of Radiology, Weill Cornell Medical College, 425 E. 61th Street, New York, NY 10065, United States of America
| | - Michele Drotman
- Weill Cornell Medical College at New York-Presbyterian Hospital, 425 East 61st Street, 9th Floor, New York, NY 10065, United States of America
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3
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Aggarwal A, Lazarow F, Anzai Y, Elsayed M, Ghobadi C, Dandan OA, Griffith B, Straus CM, Kadom N. Maximizing Value While Volumes are Increasing. Curr Probl Diagn Radiol 2020; 50:451-453. [PMID: 32222265 DOI: 10.1067/j.cpradiol.2020.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/09/2020] [Accepted: 02/25/2020] [Indexed: 01/04/2023]
Abstract
Radiologists are facing ever increasing volumes while trying to provide value-based care. There are several drivers of increasing volumes: increasing population size, aging population, increased utilization, gaps in evidence-based care, changes in the provider workforce, defensive medicine, and increasing case complexity. Higher volumes result in increased cognitive and systemic errors and contribute to radiologist fatigue and burnout. We discuss several strategies for mitigating high volumes including abbreviated MRI protocols, 24/7 radiologist coverage, reading room assistants, and other strategies to tackle radiologist burnout.
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Affiliation(s)
| | - Frances Lazarow
- Department of Radiology, Eastern Virginia Medical School, Norfolk, VA
| | - Yoshimi Anzai
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, UT
| | - Mohammad Elsayed
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Comeron Ghobadi
- Department of Radiology, The University of Chicago Pritzker School of Medicine, Chicago, IL
| | - Omran Al Dandan
- Department of Radiology, Imam Abdulrahman Bin Faisal University College of Medicine, Dammam, Saudi Arabia
| | - Brent Griffith
- Department of Radiology, Henry Ford Health System, Detroit, MI
| | - Christopher M Straus
- Department of Radiology, The University of Chicago Pritzker School of Medicine, Chicago, IL
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
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4
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Berman J, Moadel RM, Goldman-Yassen AE, Abraham T, Ye K, Volansky J, Goldberg-Stein S. Impact of Patient-Centered Care on the Patient Experience in Nuclear Medicine. Curr Probl Diagn Radiol 2020; 49:326-332. [PMID: 32222264 DOI: 10.1067/j.cpradiol.2020.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/10/2020] [Accepted: 02/25/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To quantify the impact of direct patient-physician interaction within a nuclear medicine pretherapy consultation clinic on the patient experience. METHODS Patients were asked to complete a survey before and after meeting with the nuclear medicine physician. During each visit, the physician provided disease-specific information, discussed the planned therapy, answered questions, and provided tip sheets and checklists to prepare the patient for therapy. RESULTS Thirty-eight patients were included in the analysis. Before consultation, 17 patients (44.7%) were "somewhat" or "extremely" familiar with the term "nuclear medicine doctor," whereas after the consultation, 33 patients (86.8%) were "somewhat" or "extremely" familiar with the term "nuclear medicine doctor" (P < 0.001). Thirteen patients (37.1%) felt they had either no understanding or a vague understanding of the therapy and no understanding of the plan for follow-up before the consultation, whereas 2 patients (5.4%) chose this response after the consultation (P < 0.001). More patients responded that they felt "generally" or "perfectly calm" toward the therapy overall after their consultation: 26 patients (68.4%) before vs 34 patients (91.9%) after consultation (P < 0.001). DISCUSSION Patient- and family-centered care in radiology includes direct physician participation in care delivery. In this report, we evaluate and measure the impact of our nuclear medicine pretherapy consultation clinic on the patient experience. We demonstrate significant impact of direct patient-physician encounters on patient anxiety, patient knowledge of the role of the nuclear medicine physician, and overall patient understanding of their treatment plan.
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Affiliation(s)
- Jesse Berman
- Department of Radiology, Montefiore Medical Center, Bronx, NY.
| | - Renee M Moadel
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. https://twitter.com/MDMoadel
| | - Adam E Goldman-Yassen
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. https://twitter.com/AdGoldmanYassen
| | - Tony Abraham
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Kenny Ye
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Juliya Volansky
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. https://twitter.com/Juliyavolansky
| | - Shlomit Goldberg-Stein
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. https://twitter.com/ShlomitGStein
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5
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Streamlining the Radiology Consultation Service in the Digital Era. J Am Coll Radiol 2017; 14:1464-1467. [DOI: 10.1016/j.jacr.2017.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 07/04/2017] [Accepted: 07/10/2017] [Indexed: 11/20/2022]
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6
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Salama GR, Sullivan C, Holzwanger D, Giambrone AE, Min RJ, Hentel KD. Improving Care and Education Through a Radiology Resident-driven Clinical Consultation Service. Acad Radiol 2017; 24:1175-1181. [PMID: 28392029 DOI: 10.1016/j.acra.2017.01.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/13/2017] [Accepted: 01/30/2017] [Indexed: 10/19/2022]
Abstract
RATIONALE AND OBJECTIVE As health care moves toward bundled payment systems and merit-based incentive models, increasing awareness of the value of the radiologist is essential. A resident-driven clinical imaging rounds (CIR) program initiated at our institution allows radiologists to actively and directly participate in the team-based medical model. A retrospective review of survey data evaluated the qualitative and quantitative effects of CIR on clinical management, communication, and education of referring providers and radiology residents. MATERIALS AND METHODS The initial 10 months of a resident-organized CIR were evaluated in a retrospective study. Twenty radiology residents and 150 internal medicine physicians and medical students participated in imaging rounds. An anonymous survey of participants was performed and results were analyzed. RESULTS Eighty-five percent of radiology resident participants completed the survey (N = 17). Approximately 30% of internal medicine participants completed the survey (N = 45). There was an overwhelming positive review of imaging rounds, with a large majority of all groups agreeing that imaging rounds improve education, communication, and patient care. CONCLUSIONS Resident-driven imaging rounds provide a valuable opportunity to improve communication, education, and patient care. We have created a CIR with a sustainable workflow that allows direct and regularly scheduled imaging-medicine consultation valued by both radiologists and internal medicine physicians, improving the quality of patient care and providing education to our radiology residents in value-based care.
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DiPiro PJ, Krajewski KM, Giardino AA, Braschi-Amirfarzan M, Ramaiya NH. Radiology Consultation in the Era of Precision Oncology: A Review of Consultation Models and Services in the Tertiary Setting. Korean J Radiol 2017; 18:18-27. [PMID: 28096715 PMCID: PMC5240488 DOI: 10.3348/kjr.2017.18.1.18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 08/11/2016] [Indexed: 11/30/2022] Open
Abstract
The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.
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Affiliation(s)
- Pamela J DiPiro
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Katherine M Krajewski
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Angela A Giardino
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Marta Braschi-Amirfarzan
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Nikhil H Ramaiya
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA
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Lee MH, Schemmel AJ, Pooler BD, Hanley T, Kennedy TA, Field AS, Wiegmann D, Yu JPJ. Workflow Dynamics and the Imaging Value Chain: Quantifying the Effect of Designating a Nonimage-Interpretive Task Workflow. Curr Probl Diagn Radiol 2016; 46:275-281. [PMID: 28049559 DOI: 10.1067/j.cpradiol.2016.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/10/2016] [Accepted: 11/13/2016] [Indexed: 11/22/2022]
Abstract
PURPOSE To assess the impact of separate non-image interpretive task and image-interpretive task workflows in an academic neuroradiology practice. MATERIALS AND METHODS A prospective, randomized, observational investigation of a centralized academic neuroradiology reading room was performed. The primary reading room fellow was observed over a one-month period using a time-and-motion methodology, recording frequency and duration of tasks performed. Tasks were categorized into separate image interpretive and non-image interpretive workflows. Post-intervention observation of the primary fellow was repeated following the implementation of a consult assistant responsible for non-image interpretive tasks. Pre- and post-intervention data were compared. RESULTS Following separation of image-interpretive and non-image interpretive workflows, time spent on image-interpretive tasks by the primary fellow increased from 53.8% to 73.2% while non-image interpretive tasks decreased from 20.4% to 4.4%. Mean time duration of image interpretation nearly doubled, from 05:44 to 11:01 (p = 0.002). Decreases in specific non-image interpretive tasks, including phone calls/paging (2.86/hr versus 0.80/hr), in-room consultations (1.36/hr versus 0.80/hr), and protocoling (0.99/hr versus 0.10/hr), were observed. The consult assistant experienced 29.4 task switching events per hour. Rates of specific non-image interpretive tasks for the CA were 6.41/hr for phone calls/paging, 3.60/hr for in-room consultations, and 3.83/hr for protocoling. CONCLUSION Separating responsibilities into NIT and IIT workflows substantially increased image interpretation time and decreased TSEs for the primary fellow. Consolidation of NITs into a separate workflow may allow for more efficient task completion.
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Affiliation(s)
- Matthew H Lee
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Andrew J Schemmel
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - B Dustin Pooler
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Taylor Hanley
- Department of Industrial and Systems Engineering, College of Engineering, University of Wisconsin, Madison, WI
| | - Tabassum A Kennedy
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Aaron S Field
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Biomedical Engineering, College of Engineering, University of Wisconsin, Madison, WI
| | - Douglas Wiegmann
- Department of Industrial and Systems Engineering, College of Engineering, University of Wisconsin, Madison, WI
| | - John-Paul J Yu
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Biomedical Engineering, College of Engineering, University of Wisconsin, Madison, WI; Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI.
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The development and implementation of a patient-centered radiology consultation service: a focus on breast density and additional screening options. Clin Imaging 2015; 39:731-4. [DOI: 10.1016/j.clinimag.2015.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/16/2014] [Accepted: 01/05/2015] [Indexed: 11/22/2022]
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10
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Charalel RA, Hentel KD, Min RJ, Sanelli PC. Adding value to health care: where radiologists may contribute. AJNR Am J Neuroradiol 2014; 35:1883-4. [PMID: 25059697 DOI: 10.3174/ajnr.a4068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- R A Charalel
- From the Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - K D Hentel
- From the Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - R J Min
- From the Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - P C Sanelli
- From the Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York.
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11
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Rosenkrantz AB, Lepor H, Taneja SS, Recht MP. Adoption of an Integrated Radiology Reading Room Within a Urologic Oncology Clinic: Initial Experience in Facilitating Clinician Consultations. J Am Coll Radiol 2014; 11:496-500. [DOI: 10.1016/j.jacr.2013.09.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 09/18/2013] [Indexed: 11/26/2022]
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12
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Academic radiology in the new health care delivery environment. Acad Radiol 2013; 20:1511-20. [PMID: 24200477 DOI: 10.1016/j.acra.2013.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 10/08/2013] [Accepted: 10/08/2013] [Indexed: 11/20/2022]
Abstract
RATIONALE AND OBJECTIVES Ongoing concerns over the rising cost of health care are driving large-scale changes in the way that health care is practiced and reimbursed in the United States. MATERIALS AND METHODS To effectively implement and thrive within this new health care delivery environment, academic medical institutions will need to modify financial and business models and adapt institutional cultures. In this article, we review the expected features of the new health care environment from the perspective of academic radiology departments. CONCLUSIONS Our review will include background on accountable care organizations, identify challenges associated with the new managed care model, and outline key strategies-including expanding the use of existing information technology infrastructure, promoting continued medical innovation, balancing academic research with clinical care, and exploring new roles for radiologists in efficient patient management-that will ensure continued success for academic radiology.
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Khorasani R. Capturing the Cognitive Input of Radiologists in the Care Process: Next-Generation Health IT Requirements. J Am Coll Radiol 2012; 9:393-4. [DOI: 10.1016/j.jacr.2012.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 03/05/2012] [Indexed: 11/26/2022]
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14
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In Favor of a Formal Billing Schedule for Inpatient Radiology Consults. J Am Coll Radiol 2011; 8:e1-2. [DOI: 10.1016/j.jacr.2010.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 11/04/2010] [Indexed: 11/19/2022]
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15
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Lysdahl KB, Hofmann BM, Espeland A. Radiologists’ responses to inadequate referrals. Eur Radiol 2009; 20:1227-33. [DOI: 10.1007/s00330-009-1640-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 07/26/2009] [Accepted: 08/30/2009] [Indexed: 11/28/2022]
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16
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Kool DR, Blickman JG. Advanced Trauma Life Support. ABCDE from a radiological point of view. Emerg Radiol 2007; 14:135-41. [PMID: 17564732 PMCID: PMC1914302 DOI: 10.1007/s10140-007-0633-x] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2007] [Revised: 05/08/2007] [Accepted: 05/19/2007] [Indexed: 12/01/2022]
Abstract
Accidents are the primary cause of death in patients aged 45 years or younger. In many countries, Advanced Trauma Life Support® (ATLS®) is the foundation on which trauma care is based. We will summarize the principles and the radiological aspects of the ATLS®, and we will discuss discrepancies with day to day practice and the radiological literature. Because the ATLS® is neither thorough nor up-to-date concerning several parts of radiology in trauma, it should not be adopted without serious attention to defining the indications and limitations pertaining to diagnostic imaging.
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Affiliation(s)
- Digna R Kool
- Department of Diagnostic Imaging, University Medical Centre Nijmegen, Geert Groote plein 10, route 667, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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17
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Abstract
OBJECTIVE Radiologic imaging examinations are being ordered beyond the margin of medical necessity. Radiologists can assess the value of imaging in a variety of clinical situations by gathering data regarding test ordering patterns and their effects on patient outcomes. CONCLUSION Emerging information technologies have the potential to facilitate the collection of data and permit the dissemination of appropriate guidelines to limit the number of unnecessary and possibly harmful examinations.
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Affiliation(s)
- Ronald H Gottlieb
- Roswell Park Cancer Institute, Elm and Carlton Sts., Buffalo, NY 14263, USA
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18
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Triantopoulou C, Tsalafoutas I, Maniatis P, Papavdis D, Raios G, Siafas I, Velonakis S, Koulentianos E. Analysis of radiological examination request forms in conjunction with justification of X-ray exposures. Eur J Radiol 2005; 53:306-11. [PMID: 15664296 DOI: 10.1016/j.ejrad.2004.02.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2003] [Revised: 02/02/2004] [Accepted: 02/10/2004] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate the adequacy of patient data and clinical information transmitted to the radiological departments by the referring clinicians in view of the justification demands concerning the radiological examinations, as those are described in the Radiation Protection Regulations of the European Union Nations. MATERIALS AND METHODS Request forms for 1708 patients referred to radiology department and 410 referred to the CT department were evaluated concerning the proper completion of the form fields. Furthermore, for CT examinations a more detailed evaluation was carried out, to assess the rationalistic use of CT within the diagnostic algorithm. RESULTS Not properly completed request forms to both departments were observed, however, the omissions were more prominent for the referrals to the radiology department, where the age and the probable clinical diagnosis was not given in 81.5 and 46% of the forms, respectively. Furthermore, the emergency indication was less cautiously used compared to the CT requests. For the CT department 33.3% of requests were justified and the final diagnosis was included in the referring doctor's probable clinical diagnosis. U/S was the examination of choice in 51% of the cases where an examination should have been performed before CT and in 70.6% of the cases where an alternative examination was proposed. CONCLUSIONS The inadequate transmission of clinical information and the large number of not fully justified CT requests observed in this study are typical examples of the various problems that radiologists have to face in order to apply the justification directives.
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Affiliation(s)
- Ch Triantopoulou
- Computed Tomography Department, Konstantopoulio-Agia Olga Hospital, 3-5 Agias Olgas, Nea Ionia, 14233 Athens, Greece.
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19
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Silverman SG, Khorasani R, Adams DF, Phillips MD, Sica GT, Mayer RJ. Multidisciplinary gastrointestinal cancer clinic: abdominal radiologist as active participant. Acad Radiol 1998; 5:694-7. [PMID: 9787840 DOI: 10.1016/s1076-6332(98)80564-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
RATIONALE AND OBJECTIVES Abdominal radiologists actively participated and provided subspecialty radiologic expertise in a multidisciplinary gastrointestinal cancer clinic that served a tertiary referral center. The purpose of this study was to evaluate the feasibility and nonradiologists' opinions of this new approach to radiologic consultation. MATERIALS AND METHODS One of four subspecialty-trained abdominal radiologists joined physicians from four other subspecialties in staffing weekly 4-hour clinic sessions. Images were reviewed, opinions on test selection and interventional options rendered, and patients met with when interventional options were considered. Radiologists were compensated a fixed sum for each session. A survey of nonradiologists' opinions about the radiologists' active participation was conducted after 15 months (61 clinic sessions). RESULTS Abdominal radiologists' active participation was feasible and highly regarded by nonradiologist physicians. Specific benefits cited in the survey included improved interpretation, more efficient use of nonradiologist physician time, and improved rapport between radiologists and nonradiologists. Nonradiologist physicians believed that patient care was improved and that the radiologists' participation should continue. CONCLUSION The active participation of abdominal radiologists in a multidisciplinary gastrointestinal cancer clinic is feasible and highly regarded by nonradiologists.
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Affiliation(s)
- S G Silverman
- Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA
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20
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Schuster DM. Hospital 2000: the interface of radiology within a combined "complementary-allopathic" medicine framework. J Altern Complement Med 1997; 1:333-7. [PMID: 9395628 DOI: 10.1089/acm.1995.1.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The field of radiology can play a crucial role in the movement beyond allopathic and complementary medicine to a true combination approach. Radiologists are proponents of minimal invasiveness and are familiar with the overreliance on diagnostic imaging tests. Their experience can be used to design appropriate applications for technology and to plan research methods to explore the questions raised by a combination medicine paradigm.
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Affiliation(s)
- D M Schuster
- Department of Radiology, Boston Veterans Administration Medical Center, Tufts University School of Medicine, Massachusetts, USA
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21
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Gottlieb RH, Hollenberg GM, Fultz PJ, Rubens DJ. Radiologic consultation: effect on inpatient diagnostic imaging evaluation in a teaching hospital. Acad Radiol 1997; 4:217-21. [PMID: 9084780 DOI: 10.1016/s1076-6332(05)80294-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
RATIONALE AND OBJECTIVES The authors evaluated radiologic consultation affecting resident physician ordering of relatively expensive imaging studies. METHODS Requisitions (n = 180) for expensive imaging studies from three general medicine floors (two consultation floors, one control floor) were prospectively evaluated. Information on the requisitions was classified as appropriate, inappropriate, or undecided if insufficient information was provided. On the consultation floors, but not the control floor, the medical residents were contacted about all studies initially considered inappropriate or undecided before they were performed. RESULTS Nine of 119 requisitions (7.6%) from the consultation floors were considered inappropriate. In three studies (2.5%) the imaging evaluation was modified as the result of the interaction with the radiologist. There was no significant difference in the total number of radiologic studies or percentage of the total that were expensive imaging studies when comparing the consultation floors with the control floor. CONCLUSION Radiologic consultation on expensive imaging studies through routine review of requisitions did not significantly change their use by house staff.
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Affiliation(s)
- R H Gottlieb
- Department of Radiology, University of Rochester School of Medicine and Dentistry, NY 14642, USA
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Markert DJ, Haney PJ, Allman RM. Effect of computerized requisition of radiology examinations on the transmission of clinical information. Acad Radiol 1997; 4:154-6. [PMID: 9061089 DOI: 10.1016/s1076-6332(97)80015-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
RATIONALE AND OBJECTIVES The authors developed a method to evaluate the availability and accuracy of clinical data proffered by clinicians when ordering radiologic examinations with a computer order-entry system. METHODS Two thousand consecutive clinical indications for a spectrum of pediatric imaging studies were scrutinized for accuracy by means of computerized chart review, verbal communication with clinical attending staff, and reference to surgical and laboratory results. The indications were classified as appropriate, incorrect, misleading, or incomplete. RESULTS Of the 2,000 stated indications, 1,464 (73%) provided a reasonable, if minimal, amount of clinical information; however, in 376 (19%) cases the diagnosis or proximate indication was incorrect, in 108 (5%) cases the data were incomplete, and in 52 (3%) cases the information was misleading. CONCLUSION Computer order-entry systems can improve the transmission of clinical information but they allow misinformation to be provided.
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Affiliation(s)
- D J Markert
- Department of Radiology, University of Maryland Medical Center, Baltimore, USA
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Seltzer SE, Holman BL, Thrall JH, Bramson RT, Poller W. Academic radiology in a networked environment. Acad Radiol 1996; 3:865-72. [PMID: 8923907 DOI: 10.1016/s1076-6332(96)80280-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- S E Seltzer
- Department of Radiology, Harvard Medical School, Partners HealthCare, Brigham and Women's Hospital, Boston, MA 02115, USA
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