As I leave Chicago and RSNA 2012 I want to share how much I enjoyed the feeling of energy that was in the air at RSNA with great hope that all of the 60,000 attendees carry the energy and message of “Patients First” home with them in all the work we do!
Health IT Tools for Improving Quality In Radiology
-define objective
-set initial goal
-use relevant metric directly related to your quality initiative
Good metrics are:
-easily explainable
-automated
-use existing framework
Metrics can be based on:
Right exam
Right report
Right communication (critical findings)
Or much more complex, but must be measurable
Change Management in Radiology-a Radiology Leadership Academy Course
-Humans resist change even positive
-culture trumps strategy
-sell problem before solution
-18% of GNP is spent on Healthcare, government pays for 50% of this
-unsustainable growth, some studies say this could be as high as 50% of our GNP in next 20 years
Challenges
-provide patient centered service-extend hours of operation, focus on patient safety-report on timeliness-give patients access to reports .
-take time to communicate with patients
Response
-embrace CQI
-account for org culture in planning
Culture, not strategy or vision is the most powerful force
-leadership needs to speak with one voice, walk the talk, involve input from all layers
-leadership is getting something you want done by someone else because he or she wants to do it-Dwight D. Eisenhower
-in 1990 1% of suspected appendicitis patients were CT scanned , 23 percent of appendixes removed were normal
-2007 only 1.7 percent of appendixes removed were normal due to rapid increase in use of CT to 91%
IT for Radiation Exposure Reduction
Open source dose tracking software
Radiance
-CT Techs are often scolded by radiologists for cutting something off in a study so often the scan more than is really needed just to ensure they get everything. If this field of view creep isn’t monitored with dose in mind it can lead to unneccesay higher rad dose exposure.
-default protocols can often be optimized to decrease dose exposure
-tackling the highest dose studies first is a way to make a quick impact
-dose exposure can also be reduced proactively using Decision Support software to guide providers to lower dose studies during physician order entry
-ACR national radiology data registry is a source to compare where your institution compares.
-49% of medical radiation exposure is from CT, 25% Nuc Med.
-Automated extraction system to query PACS for dose data for newer scanners that provide this in the DICOM data .
Link to reference for Radiation Dose SOPclasses:
radiation dose SOP classes
Mike Hall, Sr. Director Software Customer Services (on right) and I
Helen F. Routh, Sr. Vice President, Cardiology Informatics & Enterprise Imaging Informatics (on left) Stacy Gillen VP, Software Customer Service, Philips Clinical Informatics (on right)
The Philips Booth at RSNA is huge as always! It seemed to take forever when I walked the perimeter to capture this panoramic view:
Philips Innovations Article-International Business Times
Product Idea derived from Decision Support Presentation
– My idea is to create a WFL dashboard tool that would allow the Radiologist to quickly validate the appropriateness of the exam ordered for the clinical findings, allowing the Radiology Administrator to run reports showing if their referring physicians need education or decision support tools to help them order more appropriate exams driving cost reduction and raising facility imaging exam appropriateness and providing better patient care by reducing radiation exposure.
Sezander's Blog 