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Critical Test Results Radiology as a case example

Critical Test Results Radiology as a case example. Ramin Khorasani, MD, MPH Vice Chair, Department of Radiology Director, Center for Evidence-Based Imaging Director, Medical Imaging IT Brigham and Women’s Hospital Associate Professor Harvard Medical School.

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Critical Test Results Radiology as a case example

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  1. Critical Test ResultsRadiology as a case example Ramin Khorasani, MD, MPH Vice Chair, Department of Radiology Director, Center for Evidence-Based Imaging Director, Medical Imaging IT Brigham and Women’s Hospital Associate Professor Harvard Medical School

  2. What does this safe practice address? • Optimal communication of clinical information among caregivers-- ‘closing the loop’ • Suboptimal communication of critical test results can lead to delayed diagnosis, treatment and harm to patients • E.g. abnormal mammogram

  3. How?People • Leadership • Is quality and safety part of your DNA? • Is it expressed? • CEO, CMO, patient safety officers, clinical leaders • Clinical leadership-Chair in radiology • Change management skills • Why? Why now? Vision? Communication….Institutionalizing change • Leading ChangeHBR March 1995

  4. How?Process • Building team • Define policy and procedure • Communicate • Measure, measure, measure… • Implement • Measure, measure, measure… • Control gains, improve • Measure, measure, measure…

  5. What? Need policies and procedures (include definitions/measures): • What is critical test result • Categories of critical results: • E.g. Immediately life threatening, urgent, other • Time-frame per category for communication to care-giver • Verifiable method of communication- • To ensure critical nature of result is understood • No emails • Escalation procedures for communication • Detailed documentation of communication in the finalized radiology report-must be auditable • Metric for compliance with policy • Interventions for improvement-measure

  6. Policies and procedures • Notification and tracking of critical results.doc

  7. How?Technology • Technology: We must have a systems approach, but can’t wait- MUST START NOW -will improve with technology • Technology solutions, integration standards EXIST TODAY • Need to promote and encourage their adoption • [Optimal Electronic Medical Records will be virtual solutions, integrated based on standards to promote patient-centered, evidence-based innovations] • Broader adoption will continue to mature solutions to better serve our patients and the quality and safety movement

  8. Technology: What can you do? • As leaders, get involved in technology decision making- they are quality and safety NOT IT decisions- you must be accountable • Demand, purchase, adopt patient-centered, evidence-based solutions that are enabled with integration standards • When you settle for less you put your patients at risk • The right technology solutions will reduce waste and find the money in your practice to fund tomorrow’s quality and safety improvements

  9. Finally: ‘Closing the loop’ • It is all about Leadership • Clinical leadership- • Chair in radiology • Quality and safety • Other Chairs

  10. Thank You!rkhorasani@partners.orghttp://cebi.partners.org

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