Larocque Natasha, Brook Olga R, Kavandi Hadiseh, Brook Alexander, Rawson James V
From the Department of Radiology, Hamilton General Hospital, McMaster University, 237 Barton Street E, Hamilton, ON, Canada L8L 2X2 (N.L.); and Department of Radiology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (N.L., O.R.B., H.K., A.B., J.V.R.).
Radiographics. 2023 Apr;43(4):e220121. doi: 10.1148/rg.220121.
The use of national guidelines for the management of incidental radiologic findings remains low. Therefore, improving adherence to and consistency with follow-up recommendations for incidental findings was undertaken in a large academic practice. A gap analysis was performed, and incidental findings of abdominal aneurysms for which reporting management recommendations could be improved were identified. The Kotter change management framework was used, and institution-specific dictation macros were developed and implemented in February 2021 for the management of abdominal aortic aneurysms (AAAs), renal artery aneurysms (RAAs), and splenic artery aneurysms (SAAs). A retrospective medical record review was conducted for February through April in 2019, 2020, and 2021 to assess reporting adherence and imaging and clinical follow-up. Personal feedback was provided to radiologists in July 2021 with repeat data collection in September 2021. A significant increase in the number of correct follow-up recommendations was reported for incidental AAAs and SAAs after implementation of the macro ( < .001). However, there was no significant change for RAAs. Providing personal feedback to radiologists further improved adherence with standard recommendation macros for common findings and dramatically increased adherence for rare findings such as RAAs. New macros resulted in an increase in AAA and SAA imaging follow-up ( < .001). Institution-specific dictation macros were found to improve adherence to reporting recommendations for incidental abdominal aneurysms, with further improvement seen after feedback, which can have a significant effect on clinical follow-up. RSNA, 2023.
国家关于偶发性放射学检查结果管理指南的使用率仍然很低。因此，在一个大型学术机构中开展了提高对偶发性检查结果随访建议的依从性和一致性的工作。进行了差距分析，并确定了腹主动脉瘤的偶发性检查结果，其报告管理建议有待改进。采用了科特变革管理框架，并于2021年2月开发并实施了机构特定的听写宏指令，用于管理腹主动脉瘤（AAA）、肾动脉动脉瘤（RAA）和脾动脉动脉瘤（SAA）。对2019年、2020年和2021年2月至4月的病历进行了回顾性审查，以评估报告依从性以及影像和临床随访情况。2021年7月向放射科医生提供了个人反馈，并于2021年9月再次收集数据。实施宏指令后，偶发性AAA和SAA的正确随访建议数量显著增加（<.001）。然而，RAA没有显著变化。向放射科医生提供个人反馈进一步提高了对常见检查结果标准建议宏指令的依从性，并显著提高了对RAA等罕见检查结果的依从性。新的宏指令导致AAA和SAA影像随访增加（<.001）。发现机构特定的听写宏指令可提高对偶发性腹主动脉瘤报告建议的依从性，反馈后依从性进一步提高，这可能对临床随访产生重大影响。RSNA，2023年。
