RSNA: Critical results reporting begins with staff buy-in, education

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CHICAGO—The keys to successfully implementing critical test results (CTR) reporting software are staff and referring physician education and buy-in, according to a RSNA poster presentation from staff at Summa Health System in Akron, Ohio.

Rolling out a new technology can meet with some initial resistance from users, explained Daniel Finelli, MD. Summa Health System credited the personnel factors—education, buy-in, nurse coordination, persistence—as key factors to the success of its program. “In our experience, the technology helps greatly with the audit and documentation issues for [the Joint Commission], but we practice for our patients and physicians,” said Finelli.

Finelli and colleagues reported on their facility’s use of CTR over a three-year period. Spurred to begin a formal CTR process in 2007 by a Joint Commission initiative, they have been performing CTR documentation using software integrated into their PACS since mid-2009. Test results are classified either as red, meaning they are of immediate clinical significance and referring physicians must be called directly within 60 minutes, or yellow, meaning non-critical. Yellow results could either be communicated directly or by using the communication features of the CTR system.

Radiologists were educated on the process’ three guiding principles:

-          See it, phone it, flag it and document it;

-          Minimize the time you are the only one who knows what’s going on; and

-          If it was your grandmother, would you call, or rely on routine reporting methods?

Results showed that of the 13,159 CTR events in the reporting period, 28.2 percent were red and 71.8 were yellow. Of the red events, 88.7 percent were communicated directly physician-to-physician. Finelli and colleagues noted that 58 percent of all CTRs, red or yellow, were directly communicated, with the CTR software used only for documentation and audit purposes in those cases.

The poster presentation is course number LL-QSE-MO3 and can be located in the Lakeside Learning Center during the RSNA annual meeting.