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规范多学科病例讨论会并改善转诊医生与放射科医生之间的沟通:一项质量改进计划。

Standardizing Multidisciplinary Case Conferences and Improving Communication Between Referring Physicians and Radiologists: A Quality Improvement Initiative.

作者信息

Elias Zeyad, Tarique Usman, Veit-Haibach Patrick, Kielar Ania Z

机构信息

Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.

出版信息

Can Assoc Radiol J. 2025 May;76(2):203-211. doi: 10.1177/08465371241281055. Epub 2024 Sep 18.

DOI:10.1177/08465371241281055
PMID:39291994
Abstract

Assess the effectiveness of standardizing multidisciplinary case conferences (MDCs). Anonymous electronic surveys gauged opinions of abdominal radiologists engaged in recurring MDCs. A standardized Excel template, following Cancer Care Ontario guidelines and relevant literature, was distributed to MDC managers. Physicians were instructed to send cases 36 hours prior to MDC. Template adherence was assessed at 1.5 and 8 months. A follow-up survey at 4 months evaluated the intervention's effectiveness. 27/34 abdominal radiologists provided 47 baseline responses, and 12 delegated radiologists provided 23 follow-up responses. "Often/always" being provided the image's location increased from 36% (17/47) at baseline to 70% (16/23) at follow-up. Non-adherence to the 36-hour cut-off decreased from 36% (16/45) to 17% (4/23). 72% disagreed that uploading remote imaging to hospital servers is easy (33/46), similar to follow-up (18/23, 78%). In assessing the intervention, 41% noted improved standardization (9/22), another 41% considered MDCs already standardized (9/22), and 18% reported no change (4/22). Those reporting no change experienced a higher frequency of non-adherence to the 36-hour cut-off (3/4, 75%) than others (1/18, 6%), and less frequent "often/always" ratings for image location being provided (3/4, 75%) than others (2/18, 11%). 89% (25/28) of MDCs adhered to the template. Issues regarding last-minute add-on cases may be mitigated through EPIC force functions. Artificial intelligence advancements may assist in retrieving external images and patient information. Adherence to MDC standardization was high, allowing for more efficient preparation, potentially reducing radiologist administrative burdens. Future force functions and artificial intelligence integration into electronic patient records may further augment this.

摘要

评估多学科病例讨论会(MDC)标准化的有效性。通过匿名电子调查收集参与定期MDC的腹部放射科医生的意见。按照安大略癌症护理指南和相关文献,向MDC管理人员分发了标准化的Excel模板。要求医生在MDC召开前36小时发送病例。在1.5个月和8个月时评估模板的依从性。在4个月时进行的后续调查评估了干预措施的有效性。27/34名腹部放射科医生提供了47份基线回复,12名委托放射科医生提供了23份后续回复。“经常/总是”能得知图像位置的比例从基线时的36%(17/47)增至后续的70%(16/23)。未遵守36小时期限的比例从36%(16/45)降至17%(4/23)。72%的人不同意上传远程影像到医院服务器很容易(33/46),后续情况类似(18/23,78%)。在评估干预措施时,41%的人指出标准化有所改善(9/22),另有41%的人认为MDC已经标准化(9/22),18%的人报告无变化(4/22)。报告无变化的人未遵守36小时期限的频率更高(3/4,75%),而其他组为(1/18,6%);得知图像位置的“经常/总是”评分频率更低(3/4,75%),而其他组为(2/18,11%)。89%(25/28)的MDC遵守了模板。通过EPIC强制功能可能会缓解最后时刻添加病例的问题。人工智能的进步可能有助于检索外部影像和患者信息。对MDC标准化的依从性很高,有助于更高效地准备,可能减轻放射科医生的行政负担。未来将强制功能和人工智能集成到电子病历中可能会进一步增强这一点。

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