Joseph Mack MS, BA, Presenter: Nothing to Disclose

Steven P. Braff MD, Abstract Co-Author: Nothing to Disclose

Kristen K. DeStigter MD, Abstract Co-Author: Research Grant, Koninklijke Philips NV Consultant, Koninklijke Philips NV Medical Advisory Board, McKesson Corporation

The hospital high reliability strategy provided  Radiology and the imaging informatics team the opportunity to bring forward a set of IT projects that were consistent with hospital strategic objectives.  The clinical vision provided by Radiology, the support of the hospital to provide the capital investment for new software and the collaboraton between IT and Radiology clinical teams that brought the projects to fruition is an excellent example of organizational focus.

The Institute of Medicine (IOM) has stressed the urgency of transforming hospitals into places where each patient receives the best quality care every time,  setting a goal for hospitals to become Highly Reliable Organizations.   Radiology and IT operationalize this strategy into an initiative of 4 IT projects: Integration of a Clinical Decision Support System with the EHR Installation of a Radiation Dose Management system Integrate the Electronic Health Record Data on a PACS workstation Install a Critical Test Result Management for documented closed loop communication    

The integration of the EHR with the PACS systems has provided the Radiologist with patient episodic data that match the presented study.  The critical test results management system implementation did not reach the goal we had envisioned. We identified workflows and physician on call processes that required improvement. The clinical decision support system provide baselines data on imaging study ordering patterns by ordering physicians. The dose monitoring system improves quality consistency and embeds CT dose metrics in reports.

The integration of the EHR and PACS system has streamlined Radiologist access to the clinical chart. The critical test results management system implementation resulted in the development of an imaging study follow-up process for repeat studies. The clinical decision support system baseline established the ordering physician scorecard and creates a feedback loop that match individual ordering practices against evidence based data. The dose monitoring system provides statistical opportunities to measure radiation dosage per (study and device) and document organ specific exposure.  

Mack, J, Braff, S, DeStigter, K, Operationalizing a Hospital High Reliability Strategy to a Radiology Informatics Initiative.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045687.html