Type:
Educational Exhibit
Keywords:
MRI, Management, Professional issues, Radiographers, MR, Education, Equipment, Health policy and practice, Education and training, Occupational / Environmental hazards, Workforce, Retrospective, Not applicable, Performed at one institution
Authors:
A. Exconde; London/UK
DOI:
10.26044/ecr2020/C-00931
Findings and procedure details
Since August 2016 a systematic approach of cross-examination through telephone followup has become the norm to create a tailored, patient-centred approach from ward transition which accounts for the clinical requirements of inpatients. A preparation call covers; details on method and considerations around transport equipment need for close or open MRI, further categorisation of claustrophobia or their body habitus status, and a decision when the scan will happen taking clinical urgency into account. This confirms that the online request for MRI is good to be scanned. If any of the questions are deemed unclear, such as capacity, pregnancy and implant issues, this will be investigated, and a final decision relayed to the referrer.
Table 2 shows the inpatient activity for the period August 2015 to July 2018, wherein 5333 scans were performed and 75 were cancelled. Overall, there were more inpatients scanned than cancelled in the period given. Both scanned and cancelled inpatients were at their peak from August 2017 to July 2018, with the least amount of scanned and cancelled inpatients being for August 2015 to July 2016. In terms of scanned inpatients, there were only 881 inpatients scanned in August 2015 to July 2016. There was a recorded 2112 for August 2016 to July 2017, this was the period where the MRI pre-scan questionnaire slips were introduced. Correspondingly, the following year the number of scanned inpatients was higher still (2340). On the other hand, a slight rise in the number of slot cancellations can be seen in the succeeding years of the study period. Whereas the first year had the lowest record of 16 (1.82%), the next year had the lowest in terms of percentage 20 (0.95%) and the last year had a higher number recorded of 39 (1.66%). Although there was an apparent upsurge in terms of numbers each year, this can be accounted for as the number of patients cancelled was at a constant rate in terms of percentage considering the increase in inpatient demand through the system.
Table 3 shows the top 3 cancellation of slot reasons among inpatients who needs MRI in the hospital from August 2015 to July 2018. There has generally been a small increase in cancellation slot rates for all legends from August 2015 to July 2018, except for top two from August 2015 to July 2017. The top reason for cancellation during August 2017 to July 2018 was due to abdominal unpreparedness. Uncooperative patients for the year before, and metal implants for August 2015 to July 2016. In August 2015 to July 2017 the number of cancelled slots for the top 2 remained unchanged as both having 5 but with different reasons, anxiety and claustrophobia and discharged, respectively. August 2017 to July 2018 had a slightly higher number for second reasons based around patient refusal. Overall, the previously mentioned cancellation reasons since the beginning of the audit have all changed as it has been resolved. The data indicates that number of total cancellation slots were growing with new leading reasons and in every category, even after the introduction of MRI pre-scan questionnaire slips and option to utilise the open scanner immediately in August 2016 to July 2017. This can be attributed to the encouragement to file incidents for transparency and as a reference for improvement.