Kadakia Kevin, Pfeifer Cory M, Cao Joseph, O'Connell Ellen J, Kwon Jeannie, Browning Travis
Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
Department of Radiology, Stanford University, 300 Pasteur Dr, Palo Alto, CA, 94304, USA.
Emerg Radiol. 2020 Feb;27(1):17-22. doi: 10.1007/s10140-019-01713-z. Epub 2019 Aug 28.
The purpose of this quality improvement initiative was to study the effect of providing scorecards to emergency department providers to assess its effect on changes in utilization.
CT of the abdomen and pelvis, CT angiogram of the chest for pulmonary embolism, and CT of the head were targeted due to ordering variability, cost, and radiation exposure. The utilization rate for each provider was assessed for emergency department providers. Following this, providers were given scorecards regarding their utilization as well as their relative utilization compared with each other. Utilization was then monitored following the intervention to assess the effect of the scorecard on ordering practices.
No significant effect on the utilization of these 3 exams was found after the scorecard intervention.
Providing scorecards to make emergency department providers aware of their relative utilization does not significantly alter ordering behavior. Incentive-based systems may be required in order to lessen overutilization of these 3 commonly ordered radiology procedures in the emergency department.
本质量改进计划的目的是研究向急诊科医护人员提供记分卡，以评估其对使用情况变化的影响。
由于医嘱开具的变异性、成本和辐射暴露，将腹部和骨盆CT、用于肺栓塞的胸部CT血管造影以及头部CT作为目标。对急诊科医护人员的每位提供者的使用率进行评估。在此之后，向提供者提供有关其使用率以及与其他人相比的相对使用率的记分卡。然后在干预后监测使用率，以评估记分卡对医嘱开具行为的影响。
记分卡干预后，未发现对这三项检查的使用率有显著影响。
向急诊科医护人员提供记分卡以使其了解自己的相对使用率，并不会显著改变医嘱开具行为。可能需要基于激励的系统，以减少急诊科这三项常用放射学检查的过度使用情况。
