Imaging Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, USA.
Acad Radiol. 2013 Dec;20(12):1592-7. doi: 10.1016/j.acra.2013.09.006.
Delays between order and magnetic resonance (MR) exam often result when using the conventional paper-based MR safety screening process. The impact of an electronic MR safety screening process imbedded in a computerized physician order entry (CPOE) system was evaluated.
Retrospective chart review of 4 months of inpatient MR exam orders and reports was performed before and after implementation of electronic MR safety documentation. Time from order to MR exam completion, time from MR exam completion to final radiology report, and time from first order to final report were analyzed by exam anatomy. Length of stay (LOS) and date of service within the admission were also analyzed.
We evaluated 1947 individual MR orders in 1549 patients under an institutional review board exemption and a waiver of informed consent. Implementation of the electronic safety screening process resulted in a significant decrease of 1.1 hours (95% confidence interval 1.0-1.3 hours) in the mean time between first order to final report and a nonsignificant decrease of 0.8 hour in the median time from first order to exam end. There was a 1-day reduction (P = .697) in the time from admission to the MR exam compared to the paper process. No significant change in LOS was found except in neurological intensive care patients imaged within the first 24 hours of their admission, where a mean 0.9-day decrease was found.
Benefits of an electronic process for MR safety screening include enabling inpatients to have decreased time to MR exams, thus enabling earlier diagnosis and treatment and reduced LOS.
在使用传统的纸质磁共振（MR）安全筛查流程时，常常会出现医嘱与 MR 检查之间的延迟。本研究旨在评估嵌入电子计算机医嘱录入系统（CPOE）中的电子 MR 安全筛查流程的影响。
在实施电子 MR 安全文档之前和之后，对 4 个月的住院患者 MR 检查医嘱和报告进行了回顾性图表审查。通过检查解剖学，分析了从医嘱到 MR 检查完成、从 MR 检查完成到最终放射科报告以及从首次医嘱到最终报告的时间。还分析了住院时间（LOS）和入院日期。
在机构审查委员会豁免和知情同意豁免的情况下，我们评估了 1549 名患者的 1947 份单独的 MR 医嘱。实施电子安全筛查流程后，首次医嘱至最终报告的平均时间显著减少了 1.1 小时（95%置信区间 1.0-1.3 小时），而首次医嘱至检查结束的中位数时间无显著变化减少了 0.8 小时。与纸质流程相比，入院至 MR 检查的时间缩短了 1 天（P =.697）。除了在入院后 24 小时内进行影像学检查的神经重症监护患者外，没有发现 LOS 有显著变化，这些患者的平均 LOS 减少了 0.9 天。
电子 MR 安全筛查流程的优势包括使住院患者的 MR 检查时间缩短，从而能够更早地进行诊断和治疗，并减少 LOS。
