Howard Michelle E, McCollough Cynthia H, Leng Shuai, Yu Lifeng, Bruesewitz Mike R
Department of Radiology, Mayo Clinic, Rochester, Minnesota.
Department of Radiology, Mayo Clinic, Rochester, Minnesota.
J Am Coll Radiol. 2014 May;11(5):450-5. doi: 10.1016/j.jacr.2013.12.017. Epub 2014 Mar 19.
The purpose of this investigation was to assess the impact on workflow of the use of notification and alert values in our practice and to provide baseline data for quality improvement initiatives.
Five diagnostic clinical CT scanners were programmed with the notification and alert values recommended by the American Association of Physics in Medicine. Retrospective analysis was performed on log files to assess the frequency of and reason for notification and alert events.
Between February and September of 2012, 11,384 patients were scanned on the 5 systems. One alert occurred because of the use of bolus tracking in a morbidly obese patient, where the prescan cumulative volume CT dose index for the exam exceeded the recommended alert value of 1,000 mGy. Only 1.2 ± 0.6% of patient scans triggered a notification. Notifications were mainly triggered because of bolus tracking and/or large patient size. Protocols triggering notifications most often included CT angiography of the chest for pulmonary emboli.
Because only a small percentage of performed patient examinations triggered a notification or alert event, the impact on workflow of adopting these features was negligible. Evaluation of the logs identified trends in reasons for which notification events were triggered; these primarily included large patient size and bolus tracking. Additionally, specific protocols were identified where adjustment of notification values was deemed necessary.
本研究旨在评估在我们的实践中使用通知和警报值对工作流程的影响，并为质量改进计划提供基线数据。
五台诊断用临床CT扫描仪按照美国医学物理学会推荐的通知和警报值进行编程。对日志文件进行回顾性分析，以评估通知和警报事件的频率及原因。
在2012年2月至9月期间，这5台系统共对11384例患者进行了扫描。有一次警报是因为对一名病态肥胖患者使用团注追踪时，该检查的扫描前累积容积CT剂量指数超过了推荐的警报值1000 mGy。只有1.2±0.6%的患者扫描触发了通知。通知主要是由于团注追踪和/或患者体型较大而触发的。最常触发通知的方案包括用于肺栓塞的胸部CT血管造影。
由于只有一小部分已进行的患者检查触发了通知或警报事件，采用这些功能对工作流程的影响可以忽略不计。对日志的评估确定了触发通知事件的原因趋势；这些主要包括患者体型较大和团注追踪。此外，还确定了一些特定方案，认为有必要调整通知值。
