Referring physician indication review and evaluation process to asses justification: both radiologists and primary physicians at work!

Congress:

EuroSafe Imaging 2019

Poster Number:

ESI-0050

Type:

EuroSafe Imaging

Keywords:

Action 6 - Clinical audit tool for imaging, Action 7 - Radiation protection of children, Radioprotection / Radiation dose, Management, CT, Digital radiography, Fluoroscopy, Decision analysis, Radiation safety, Quality assurance

Authors:

M. Ulla, A. Dafouz, D. E. Andisco, S. A. A. Blanco, R. D. García-Mónaco, J. A. Sanabria

DOI:

10.26044/esi2019/ESI-0050

DOI-Link:

https://dx.doi.org/10.26044/esi2019/ESI-0050

Table 1: Hospital Italiano Imaging Department staffing.

Table 2: Hospital Italiano Imaging Department distribution of patients during 2018

Fig. 1: Screen Capture of the Hospital Italiano Intranet with the uploaded...

Fig. 2: Clinical Decision Support screen capture of the alert

Background/introduction

The increase in requests for diagnostic imaging studies has grown exponentially in the last decade, especially those of computed tomography (CT) and interventional and hemodynamic processes that deliver doses considered threshold for deterministic effects regarding the damage caused by X radiation. Referring physician medical indication of imaging studies (in paper o digital) represents the key element for the care of a patient in a diagnostic imaging service. It is therefore essential to have a process to evaluate the appropriate criteria to decide the performance of...

Description of activity and work performed

Profile of the institution Each year, the Hospital attends 2,800,000 consultations, manages 46,500 discharges and performs 52,000 surgical procedures in its 41 operating theaters. It has a capacity of 785 beds, of which 200 are for critical care, and 800 beds of home medicine. Its work team is made up of 9237 people: 3400 medical doctors, 3337 members of the health staff and 2,500 people from the administrative sectors. As for the assistance it provides, the Italian Hospital has more than 40 medical specialties, a...

Conclusion and recommendations

Our referring physician indication review and evaluation process to asses justification of X radiation examinations needed a team work. A change of culture and awareness process is necessary. The first steps were taken to create a culture of justification of imaging studies through educational actions, meetings and information tools. This plan is a long-term or ongoing activity implying change in uses and habits in the in the entire medical community.

Personal/organisational information

M. Ulla: chief quality officer of the Imaging department of Hospital Italiano de Buenos Aires, coordinating activities of the audit team in the radiology department. D. A. Dafouz: resident of the Imaging department of Hospital Italiano de Buenos Aires R. D. García-Mónaco: Head of the Imaging Department, Hospital Italiano de Buenos Aires

References

1.- https://www.iaea.org/sites/default/files/17/12/bonn-call-for-action.pdf. 2.- http://www.eurosafeimaging.org/about/call-for-action 3.-http://www.irpa.net/members/IRPAGuiding%20Principles%20on%20RP%20Culture%20-2014%20.pdf