Deployment of Enhanced Critical Imaging Result Notification (DECIRN)

部署增强型关键成像结果通知 (DECIRN)

• 批准号: 8144912
• 负责人: Ronilda Lacson
• 金额: $ 14.39万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2013-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8144912
• 关键词: Deployment; Enhanced; Critical; Imaging; Result

DESCRIPTION (provided by applicant): The Joint Commission has emphasized the need for improved communication of critical test results as one of its 2010 National Patient Safety Goals. Delays in communication of critical results pose a significant threat to patient safety by creating delays in diagnosis, which eventually leads to delays in management. In diagnostic imaging, no standards currently exist for timeliness of communication of results, for ideal communication venues, and especially for deciding which results are critical. The Brigham and Women's Hospital Center for Evidence-Based Imaging established an enterprise-wide policy as part of a three-year quality improvement initiative to enhance communication of critical imaging results. The policy includes clear guidelines and procedures for notification of referring physicians whenever critical imaging results are identified. In a pilot study, the proportion of critical results fully adherent with this policy increased from 28.6% to 94.6% over three years. This pilot evaluation, however, required manual review of individual reports and therefore only reviewed 12,193 reports in three years (less than 1%). A full-scale evaluation would provide more definitive information regarding successful implementation and adoption of this policy The proposed project therefore plans the following specific aims: (1) Implement an enterprise-wide policy and intervention for enhancing communication of critical imaging results; (2) Evaluate this intervention by comparing its impact on appropriate alert notification for critical imaging results and documented critical results that were missed by the intervention; and (3) Develop an implementation toolkit for widespread dissemination. Implementation of the CCTR policy with full deployment of an Automated Notification of Critical Results system (ANCR) will commence at the project start date. In order to evaluate the deployment of enhanced critical imaging result notification (DECIRN), we will undertake a prospective single crossover clinical trial, comparing the intervention with baseline clinical practice. With over 600,000 imaging procedures performed at the BWH and its outpatient facilities annually, fully implementing this policy would greatly promote patient safety and encourage widespread adoption. Finally, an implementation toolkit will be disseminated, which includes a full resource guide to enable other institutions to adopt the CCTR policy and enable automated notification when possible. PUBLIC HEALTH RELEVANCE: Delays in communication of critical results pose a significant threat to patient safety by creating delays in diagnosis, which eventually leads to delays in management. The Brigham and Women's Hospital (BWH) established the Communication of Critical Test Results (CCTR) policy to enhance communication of critical imaging results. This study aims to deploy an enhanced, automated implementation of this policy using Automated Notification of Critical Results, an automated critical imaging result management system to promote patient safety and encourage widespread adoption.

描述（由申请人提供）：联合委员会强调需要改善关键测试结果作为其2010年国家患者安全目标之一。关键结果交流的延迟通过在诊断中造成延迟对患者的安全构成了重大威胁，这最终导致管理层延迟。在诊断成像中，目前尚无标准，用于及时的结果，理想的沟通场地，尤其是确定哪些结果至关重要。杨百翰和妇女医院的循证成像中心建立了一项企业范围的政策，这是一项为期三年质量改进计划的一部分，以增强关键成像结果的交流。该政策包括明确的准则和程序，以通知参考医师时，每当确定批判成像结果时。在一项试点研究中，在三年内完全遵守该政策的关键结果比例从28.6％增加到94.6％。但是，该试点评估需要对单个报告进行手动审查，因此仅在三年内审查了12,193个报告（少于1％）。全面评估将提供有关成功实施和采用本政策的更明确的信息。拟议项目因此计划以下特定目的：（1）实施企业范围内的政策和干预措施，以增强关键成像结果的交流； （2）通过比较其对关键成像结果的适当警报通知的影响，评估此干预措施，并记录了干预措施所遗漏的关键结果； （3）开发一个实施工具包，以进行广泛的传播。通过全面部署关键结果系统（ANCR）的自动通知，实施CCTR策略将在项目开始日期开始。为了评估增强的关键成像结果通知的部署（DECIRN），我们将进行一项前瞻性单跨临床试验，将干预与基线临床实践进行比较。每年在BWH及其门诊设施执行超过600,000次成像程序，充分实施这项政策将极大地促进患者的安全并鼓励广泛采用。最后，将传播实施工具包，其中包括完整的资源指南，以使其他机构能够采用CCTR策略并在可能的情况下启用自动通知。 公共卫生相关性：延误关键结果通过造成诊断延迟对患者的安全构成重大威胁，最终导致管理层延迟。 Brigham and Hospital（BWH）建立了关键测试结果（CCTR）政策的沟通，以增强关键成像结果的沟通。这项研究旨在使用关键结果的自动通知，一种自动化的关键成像结果管理系统，以促进患者的安全并鼓励广泛采用。

项目成果

Retrieval of radiology reports citing critical findings with disease-specific customization.

检索放射学报告，引用针对特定疾病的定制的关键发现。

• DOI: 10.2174/1874431101206010028
• 发表时间: 2012
• 期刊: The open medical informatics journal
• 作者: Lacson,Ronilda;Sugarbaker,Nathanael;Prevedello,LucianoM;Ivan,Ip;Mar,Wendy;Andriole,KatherineP;Khorasani,Ramin
• 通讯作者: Khorasani,Ramin