Evaluation of an emergency radiology quality assurance program at a level I trauma center: abdominal and pelvic CT studies.

Abstract:

PURPOSE:To evaluate the use of a redundant system in improving quality of care in the trauma setting by examining a subset of our quality assurance program. MATERIALS AND METHODS:Five hundred thirty-one consecutive abdominal and pelvic CT reports obtained in patients with trauma at a level I trauma center from August 22, 1999, to August 21, 2000, were retrospectively reviewed. Each case was initially interpreted by a board-certified or board-eligible radiologist during evaluation in the emergency department and was subsequently reviewed by a subspecialty abdominal imaging radiologist as part of a quality assurance program. Nineteen cases were excluded because available information was incomplete, resulting in 512 cases in the current study. Cases with discordant interpretations were followed up to discern care change. RESULTS:Of the 512 trauma cases, 153 (29.9%) showed discordant readings. Review of patient records demonstrated changes in patient care in 12 (7.8%) cases. Three (2.0%) cases were reviewed from the morbidity and mortality records of the Department of Trauma Surgery as a direct result of misinterpretations. Six (4%) cases involved additional diagnostic imaging for reevaluation; in four of these six cases the quality assurance reader's interpretation was confirmed, while in the other two, the initial interpretations were favored. CONCLUSION:Findings suggest that discordant radiologic interpretations most often do not result in a change in patient care and outcome. The quality assurance program did, however, identify and lead to changes in care in a number of cases by providing clinically important additional findings.

journal_name

Radiology

journal_title

Radiology

authors

Yoon LS,Haims AH,Brink JA,Rabinovici R,Forman HP

doi

10.1148/radiol.2241011470

subject

Has Abstract

pub_date

2002-07-01 00:00:00

pages

42-6

issue

1

eissn

0033-8419

issn

1527-1315

journal_volume

224

pub_type

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