Director, Radiology Quality, Department of Radiology, Children's Healthcare of Atlanta, Atlanta, Georgia; Associate Professor, Emory University School of Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; and Co-Chair, ACR Closing the Loop TEP, honorarium.
Chief, Section of Administration, Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut; and Co-Chair, ACR Closing the Loop TEP, honorarium.
J Am Coll Radiol. 2022 Jul;19(7):881-890. doi: 10.1016/j.jacr.2022.03.017. Epub 2022 May 21.
Care gaps occur when radiology follow-up recommendations are poorly communicated or not completed, resulting in missed or delayed diagnosis potentially leading to worse patient outcomes. This ACR-led initiative assembled a technical expert panel (TEP) to advise development of quality measures intended to improve communication and drive increased completion rates for radiology follow-up recommendations.
A multistakeholder TEP was assembled to advise the development of quality measures. The project scope, limited to noncritical actionable incidental findings (AIFs), encourages practices to develop and implement systems ensuring appropriate communication and follow-up to completion.
A suite of nine measures were developed: four outcome measures include closing the loop on completion of radiology follow-up recommendations for nonemergent AIFs (with pulmonary nodule and abdominal aortic aneurysm use cases) and overall cancer diagnoses. Five process measures address communication and tracking of AIFs: inclusion of available evidence or guidelines informing the recommendation, communication of AIFs to the practice managing ongoing care, identifying when AIFs have been communicated to the patient, and employing tracking and reminder systems for AIFs.
This ACR-led initiative developed a measure set intended to improve patient outcomes by ensuring that AIFs are appropriately communicated and followed up. The intent of these measures is to focus improvement on specific areas in which gaps in communication and AIF follow-up may occur, prompting systems to devote resources that will identify and implement solutions to improve patient care.
当放射科随访建议沟通不畅或未完成时，就会出现护理缺口，导致诊断延误或遗漏，从而可能导致患者预后变差。这项由美国放射学会（ACR）牵头的计划召集了一个技术专家小组（TEP），为制定旨在改善沟通和提高放射科随访建议完成率的质量指标提供建议。
成立了一个多利益相关者的 TEP 小组，为制定质量指标提供建议。该项目的范围仅限于非危急可行动的偶然发现（AIF），鼓励实践制定和实施系统，以确保适当的沟通和完成随访。
制定了一套 9 项措施：四项结果指标包括完成非紧急 AIF（肺结节和腹主动脉瘤用例）和整体癌症诊断的放射科随访建议的闭环；五项流程指标涉及 AIF 的沟通和跟踪：包括告知建议的可用证据或指南、将 AIF 传达给负责持续护理的实践、确定何时将 AIF 传达给患者、以及使用 AIF 的跟踪和提醒系统。
这项由 ACR 牵头的计划制定了一套措施，旨在通过确保 AIF 得到适当的沟通和跟进，改善患者的治疗效果。这些措施的目的是集中改进沟通和 AIF 随访方面可能存在差距的特定领域，促使系统投入资源，识别并实施解决方案，以改善患者的护理质量。
