Chwang Wilson B, Iv Michael, Smith Jason, Kalnins Aleksandrs, Mickelsen Jake, Bammer Roland, Fleischmann Dominik, Larson David B, Wintermark Max, Zeineh Michael
From the Department of Radiology, Stanford Health Care, Lucas Center for Imaging, 1201 Welch Rd, Room P271, Stanford, CA 94305.
Radiographics. 2017 Jan-Feb;37(1):316-322. doi: 10.1148/rg.2017160035.
Functional magnetic resonance (MR) imaging is a complex, specialized examination that is able to noninvasively measure information critical to patient care such as hemispheric language lateralization ( 1 ). Diagnostic functional MR imaging requires extensive patient interaction as well as the coordinated efforts of the entire health care team. We observed in our practice at an academic center that the times to perform functional MR imaging examinations were excessively lengthy, making scheduling of the examination difficult. The purpose of our project was to reduce functional MR imaging acquisition times by increasing the efficiency of our workflow, using specific quality tools to drive improvement of functional MR imaging. We assembled a multidisciplinary team and retrospectively reviewed all functional MR imaging examinations performed at our institution from January 2013 to August 2015. We identified five key drivers: (a) streamlined protocols, (b) consistent patient monitoring, (c) clear visual slides and audio, (d) improved patient understanding, and (e) minimized patient motion. We then implemented four specific interventions over a period of 10 months: (a) eliminating intravenous contrast medium, (b) reducing repeated language paradigms, (c) updating technologist and physician checklists, and (d) updating visual slides and audio. Our mean functional MR imaging acquisition time was reduced from 76.3 to 53.2 minutes, while our functional MR imaging examinations remained of diagnostic quality. As a result, we reduced our routine scheduling time for functional MR imaging from 2 hours to 1 hour, improving patient comfort and satisfaction as well as saving time for additional potential MR imaging acquisitions. Our efforts to optimize functional MR imaging workflow constitute a practice quality improvement project that is beneficial for patient care and can be applied broadly to other functional MR imaging practices. RSNA, 2017.
功能磁共振成像(Functional magnetic resonance,MR)是一项复杂的专业检查,能够无创测量对患者护理至关重要的信息,如半球语言优势化(1)。诊断性功能磁共振成像需要患者广泛参与,以及整个医疗团队的协同努力。我们在一家学术中心的实践中观察到,进行功能磁共振成像检查的时间过长,使得检查安排困难。我们项目的目的是通过提高工作流程效率,使用特定质量工具推动功能磁共振成像的改进,来缩短功能磁共振成像采集时间。我们组建了一个多学科团队,并回顾性分析了2013年1月至2015年8月在我们机构进行的所有功能磁共振成像检查。我们确定了五个关键驱动因素:(a)简化方案,(b)持续的患者监测,(c)清晰的视觉幻灯片和音频,(d)提高患者理解,(e)尽量减少患者运动。然后,我们在10个月的时间里实施了四项具体干预措施:(a)取消静脉造影剂,(b)减少重复的语言范式,(c)更新技术人员和医生的检查表,(d)更新视觉幻灯片和音频。我们的功能磁共振成像平均采集时间从76.3分钟减少到53.2分钟,而我们的功能磁共振成像检查仍保持诊断质量。结果,我们将功能磁共振成像的常规安排时间从2小时减少到1小时,提高了患者的舒适度和满意度,同时节省了进行其他潜在磁共振成像采集的时间。我们优化功能磁共振成像工作流程的努力构成了一个实践质量改进项目,有利于患者护理,并且可以广泛应用于其他功能磁共振成像实践。RSNA,2017年。