Ruess Lynne, Thompson Benjamin P, Mesi Erin L, Chmil Margarita, Zumberge Nicholas A, Jorgenson Kari, Krishnamurthy Rajesh
From the Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio.
Center for Clinical Excellence, Nationwide Children's Hospital, Columbus, Ohio.
Pediatr Qual Saf. 2023 Aug 7;8(4):e673. doi: 10.1097/pq9.0000000000000673. eCollection 2023 Jul-Aug.
The involvement of pediatric imaging professionals in quality improvement (QI) in our department was low, with few available informatics tools to report issues or suggest improvement opportunities in a timely and efficient manner. We aimed to increase QI engagement in radiology by creating a real-time, encounter-specific reporting tool embedded into the clinical imaging workflow.
A multidisciplinary team outlined requirements for a new electronic quality-reporting tool, including point-of-care access during imaging workflow and simultaneous automatic capture of encounter-specific clinical information from the hospital information system. Information system experts created a user-friendly interface for categories based on stages of imaging workflow (Planning, Acquisition, Processing, Interpretation, Communication, and Data Collection). Team members trained all department staff. Quality coordinators sorted entries and monitored personnel engagement for two 36-week periods: immediately after launch and 3 years later. Descriptive statistics were used to analyze proposed and completed QI projects during these periods.
There were 1,498 entries during the first 36 weeks. Ninety-three percent of radiologists and 56% of technologists participated. Three years later, there were 1,251 entries in 36 weeks. Data collection entries for established QI projects increased from 380 (25%) to 487(39%). The engagement continued among radiologists but decreased among technologists over time. Submissions for QI projects increased from baseline. The project completion rate increased.
We created a QI reporting tool embedded into the clinical imaging workflow, which improved the participation of our imaging professionals and increased the number of completed QI projects.
在我们科室，儿科影像专业人员参与质量改进（QI）的程度较低，且几乎没有可用的信息工具来及时、高效地报告问题或提出改进机会。我们旨在通过创建一个嵌入临床影像工作流程的实时、特定检查报告工具，来提高放射科的QI参与度。
一个多学科团队概述了一种新的电子质量报告工具的要求，包括在影像工作流程中的即时护理访问，以及从医院信息系统中同时自动获取特定检查的临床信息。信息系统专家基于影像工作流程的阶段（规划、采集、处理、解读、沟通和数据收集）为各个类别创建了一个用户友好的界面。团队成员对科室所有员工进行了培训。质量协调员对条目进行分类，并在两个36周的时间段内监测人员参与情况：推出后立即进行以及3年后。使用描述性统计分析这些时间段内提出和完成的QI项目。
在最初的36周内有1498条条目。93%的放射科医生和56%的技术人员参与其中。三年后，36周内有1251条条目。既定QI项目的数据收集条目从380条（25%）增加到487条（39%）。随着时间的推移，放射科医生的参与度持续存在，但技术人员的参与度有所下降。QI项目的提交量从基线水平有所增加。项目完成率提高。
我们创建了一个嵌入临床影像工作流程的QI报告工具，这提高了我们影像专业人员的参与度，并增加了完成的QI项目数量。
