By Mark Watts
Alameda Health is a level one trauma center in the heart of Oakland. They have more work than they can handle! As a safety net hospital, they treat all in need. This workload was documented in the documentary “The Waiting Room.”
The emergency room provides for all levels of acuity. This open-to-all approach leads to stress on the resources. They need to improve efficiency to meet the demands. The CNO called a meeting and asked for suggestions to improve the patient throughput in the emergency room. Alameda Health is a teaching hospital with employed physicians. They do not have a profit motive and do not get paid to do more work. The use of voice recognition AI and effective PACS was already provided. The only improvement they could come up with was to have the radiologist work with the emergency room to reduce unnecessary imaging exams. This is a common problem in health care nationally.
Radiologists play a crucial role in helping reduce the number of unnecessary imaging studies ordered by emergency room (ER) doctors. Here are some brainstormed ways in which radiologists can contribute to this goal:
- Implement clinical decision support systems: Radiologists can work with hospital administrators and IT departments to implement clinical decision support systems. These systems provide evidence-based guidelines and recommendations for ordering appropriate imaging studies, helping ER doctors make more informed decisions.
- Provide educational resources: Radiologists can develop educational materials, such as guidelines, protocols, and case studies, to educate ER doctors about appropriate imaging utilization. This can include highlighting situations where imaging may not be necessary or suggesting alternative diagnostic approaches.
- Develop evidence-based imaging guidelines: Collaborating with other health care professionals, radiologists can participate in the development of evidence-based imaging guidelines specific to the ER setting. These guidelines can help standardize imaging practices and reduce unnecessary studies.
- Act as consultants: Radiologists can make themselves available as consultants to ER doctors, providing expertise in imaging utilization. They can review clinical histories, discuss appropriate imaging options, and help determine the most effective imaging modalities for specific clinical scenarios.
- Establish clinical pathways: Working with ER physicians, radiologists can establish clinical pathways or protocols for specific clinical conditions. These pathways outline the appropriate use of imaging studies based on best practices and evidence, reducing unwarranted variations in ordering practices.
- Provide real-time feedback: Radiologists can provide real-time feedback to ER doctors regarding the appropriateness of imaging studies. This feedback can be incorporated into quality improvement initiatives and can help ER physicians better understand the impact of their ordering patterns.
- Participate in multidisciplinary conferences: Radiologists can actively participate in multidisciplinary conferences where patient cases are discussed. By contributing their expertise, they can help guide discussions regarding the necessity of imaging studies, fostering a collaborative approach to patient care.
- Develop imaging utilization dashboards: Radiologists can collaborate with hospital administrators and data analysts to develop imaging utilization dashboards. These dashboards can provide ER doctors with information on their own ordering patterns compared to benchmarks and peer groups, promoting awareness and self-reflection.
- Offer second opinions: Radiologists can offer second opinions on imaging requests from ER doctors. By providing an alternative perspective, they can help ensure that imaging studies are appropriate and necessary, potentially avoiding unnecessary tests.
- Conduct research on imaging utilization: Radiologists can contribute to research efforts focused on imaging utilization in the emergency room setting. By identifying trends, best practices, and areas of improvement, research findings can inform strategies to reduce unnecessary imaging studies.
It’s important to note that effective collaboration and communication between radiologists and ER physicians are essential for achieving the goal of reducing unnecessary imaging studies. By working together, they can ensure that patients receive appropriate care while minimizing unnecessary radiation exposure and health care costs. I welcome your feedback and suggestions you have found successful in your emergency departments.
Mark Watts is an experienced imaging professional who founded an AI company called Zenlike.ai.
