Khan Marwa, Khaleeq Tahir, Theivendran Kanthan
Trauma & Orthopaedic Surgery Department, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
Trauma & Orthopaedic Surgery Department, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
BMJ Open Qual. 2025 May 8;14(2):e003126. doi: 10.1136/bmjoq-2024-003126.
Neurosurgical emergencies, including cauda equina syndrome, traumatic spinal cord injuries and traumatic brain injuries, require timely diagnosis and intervention to prevent severe morbidity and mortality. Delays in these cases often stem from inefficiencies in transferring investigational images from district hospitals to external neurosurgery units.
This quality improvement project aimed to reduce image transfer time at Sandwell and West Birmingham Hospitals Trust (SWBH) to the Queen Elizabeth Hospital Birmingham neurosurgery unit. It sought to empower Trauma and Orthopaedics (T&O) doctors to independently transfer images using an image exchange portal (IEP) software, bypassing reliance on traditional picture archiving and communication teams.
Over three Plan-Do-Study-Act cycles (February and September 2024), T&O registrars and junior doctors were trained to use the IEP. Additional instructional resources were provided following low compliance. Image transfer times and neurosurgical response times were compared preintervention and postintervention.
The intervention reduced the average time from referral to image transfer from 18 hours to 3.6 hours across the cycles. The proportion of images transferred within 1 hour increased from 36% to 59%, and 87% of images were reviewed by neurosurgery within 6 hours by the final cycle. Operational cost savings were achieved by reducing reliance on IT services, radiographers and length of stay.
This project improved the timeliness of image transfer and neurosurgical care at SWBH. Although IEP software proved effective locally, its broader applicability across UK hospitals remains uncertain. The findings highlight the need for a national solution to streamline image transfers and further research to enhance technologies supporting rapid investigative imaging. Empowering front-line clinicians with appropriate tools provides a replicable model for addressing similar challenges in other institutions.
包括马尾综合征、创伤性脊髓损伤和创伤性脑损伤在内的神经外科急症需要及时诊断和干预，以防止严重的发病率和死亡率。这些病例的延误往往源于将检查图像从地区医院传输到外部神经外科单位的效率低下。
这个质量改进项目旨在减少桑德韦尔和西伯明翰医院信托基金（SWBH）向伯明翰伊丽莎白女王医院神经外科单位传输图像的时间。它试图使创伤与矫形外科（T&O）医生能够使用图像交换门户（IEP）软件独立传输图像，不再依赖传统的图像存档和通信团队。
在三个计划-执行-研究-行动周期（2024年2月和9月）中，对T&O注册员和初级医生进行了使用IEP的培训。在依从性较低后提供了额外的指导资源。比较了干预前后的图像传输时间和神经外科响应时间。
在各个周期中，干预将从转诊到图像传输的平均时间从18小时减少到了3.6小时。1小时内传输的图像比例从36%增加到了59%，到最后一个周期，87%的图像在6小时内得到了神经外科的审查。通过减少对信息技术服务、放射技师的依赖以及住院时间，实现了运营成本的节约。
该项目提高了SWBH图像传输和神经外科护理的及时性。尽管IEP软件在当地证明是有效的，但其在英国医院的更广泛适用性仍不确定。研究结果凸显了需要一个全国性的解决方案来简化图像传输，并进行进一步研究以增强支持快速检查成像的技术。为一线临床医生提供适当的工具为其他机构应对类似挑战提供了一个可复制的模式。
