Pop quiz. A leader whose work helped change the world greatly for the better once said, “I think one’s feelings waste themselves in words; they ought all to be distilled into actions which bring results.” Who was it?
Answer: the founder of modern nursing, Florence Nightingale. And when she spoke, she didn’t have to spell out for whom she sought results. She was “patient-centric” to the core of her being without ever stopping to think there might be any other way to care for the ill, the injured and the otherwise infirm.
Times have changed a lot since the 19th century, but human nature never does. It’s even easier now than it was then to get distracted by the hows of healthcare—the tools and technologies, the protocols and regulations, the resources and the lack thereof—and lose sight of the why. The latter being the patient.
In recent times, radiology as a profession has happily refocused on this patently obvious yet easily overwhelmed aspect of its mission. Population health is vital. Improving care while reducing costs is critical. But it’s really all about the patient, as RSNA’s Radiology Cares campaign, ACR/RSNA’s RadiologyInfo.org and Strategic Radiology’s My-Radiologist.com all attest just by being there.
The 2015 Patient-centric Imaging Awards honor imaging teams that have clearly distilled their words as well as their feelings into actions that bring results. In making our selections this year, we were especially watchful for bold, proactive initiatives that combined spirited team building with creative problem solving and innovative opportunity capitalizing—all on behalf of the patient.
We weren’t disappointed. To see why, check out the winners in their own words.
Lakeland Health in St. Joseph, Mich.
Organization type: Small to medium nonteaching hospital
Project: Patient-based radiation safety program
|“We have been very excited about our physicians’ willingness to jump on board with the program,” Angelica Padilla, Lakeland Health’s director of radiology, told HealthImaging. “The feedback has been very positive from both physicians and patients. The implementation of our EHR has given us the opportunity to provide safe patient care through this program.”|
With the implementation of an EHR in 2012, Lakeland re-launched a multi-faceted radiation safety program to ensure the safety of young adult and pediatric patients receiving radiation exposure for benign diagnosis. Through collaboration with the radiology department and EHR team the, following process was created and presented to the medical staff for approval:
A Patient-Based Radiation Safety Committee was formed consisting of the Radiation Safety Officer (RSO), Chief Radiologist and Radiology Director. Alert thresholds were created based on the number of CT studies completed rather than measuring exact dosages because of the number of variables involved in this process. The following three base criteria were used for identifying at-risk patients:
- Patient less than 40 years of age
- Benign diagnosis
- Five CT studies of the neck, chest, lumbar spine and abdomen or abdomen/pelvis
A weekly report was created to capture additional information for patients who matched these criteria, including previous CT scan types and dates, past diagnosis and patient history. The report also includes CT studies from external organizations based on the study type and body region entered when imported into Lakeland’s EHR.
An initial review of the report is done by the Director of Radiology to identify potential candidates for the radiation safety program based on their medical and surgical history. These candidates are then reviewed by the Radiation Safety Committee to determine entrance into program. If a patient meets the criteria for the program, a Best Practice Advisory (BPA) is added to the patient chart within the EHR. The patient’s primary care physician will also receive a letter indicating the patient’s inclusion in the program.
When an additional CT scan is ordered for this patient the ordering provider will receive a BPA alert stating, “This patient is being followed by the Patient Based Radiation Safety Committee. Please consider a non-ionizing exam such as MRI or ultrasound for this patient or consult with a radiologist.”
The BPA does not prevent the ordering of CT scans and can be bypassed. It does, however, trigger a review of the need for the exam. If the patient continues to have additional scans and reaches a threshold of 10 CTs, three additional safety measures