Department of Radiology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Department of Radiology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Curr Probl Diagn Radiol. 2022 Mar-Apr;51(2):171-175. doi: 10.1067/j.cpradiol.2021.03.003. Epub 2021 Mar 17.
Assimilate a general radiology division into a subspecialty-focused radiology department at an academic medical center.
This Institutional Review Board-approved quality improvement initiative was performed at an academic medical centers' subspecialty-focused academic radiology department, aiming to assimilate a general radiology division providing interpretive services for a distributed set of community ambulatory practices. An Oversight Committee charged by the department chair created a charter with unambiguous goal, timelines, clear decision-making, and conflict resolution processes. The Committee assessed the resources and clinical capabilities of the general radiologists, and the anticipated shift in exam volume from the community into subspecialty divisions. Primary outcome, percentage of targeted organ systems-specific interpretations by general radiologists based on assigned subspecialty division, and secondary outcome of report turnaround time (TAT) for all ambulatory exams, were compared before and after sub-specialization.
Among 10 general radiologists, 4.5 were assigned to subspecialty divisions; 5.5 continued to cover an independent general radiology practice in a for-profit delivery network. In the 5 months' post-transition, a total 86.6% (11,668/13,477) of reports by the integrated general radiologists were within designated subspecialty divisions vs 23.9% (2,586/10,829) pre-transition (P < 0.01). There was no change in ambulatory radiology report TAT for non-urgent care center (UCC) or UCC exams pre- vs post-integration.
A quality improvement initiative with unambiguous decision-making and conflict resolution processes incorporated a general radiology practice (radiologists and exams) into a subspecialty-focused academic radiology practice without negatively impacting TAT metrics. Future studies would be needed to assess impact on quality of interpretations.
将一个综合放射科并入学术医疗中心的专注于亚专业的放射科。
这项经机构审查委员会批准的质量改进计划是在专注于亚专业的学术放射科的学术医疗中心的亚专业放射科进行的，旨在将一个提供解释服务的综合放射科并入专注于亚专业的学术放射科，该放射科为分布在社区的多个门诊实践提供服务。由系主任任命的监督委员会制定了一份章程，其中明确规定了目标、时间表、明确的决策和冲突解决流程。委员会评估了普通放射科医生的资源和临床能力，以及从社区转移到亚专业部门的预期检查量。主要结果是根据指定的亚专业部门，普通放射科医生对特定器官系统的检查的百分比，次要结果是所有门诊检查的报告周转时间（TAT）。在专业化前后进行了比较。
在 10 名普通放射科医生中，有 4.5 名被分配到亚专业部门；有 5.5 名继续在一个盈利性的交付网络中独立开展普通放射科业务。在过渡后的 5 个月内，整合后的普通放射科医生的报告中，有 86.6%（11668/13477）在指定的亚专业部门内，而在过渡前为 23.9%（2586/10829）（P<0.01）。非紧急护理中心（UCC）或 UCC 检查的门诊放射学报告 TAT 在整合前后没有变化。
一项具有明确决策和冲突解决流程的质量改进计划，将一个普通放射科（放射科医生和检查）并入专注于亚专业的学术放射科实践，而不会对 TAT 指标产生负面影响。未来还需要进行研究，以评估对解释质量的影响。
