Electronic MR safety process improves screening efficiency

Utilizing an electronic MR safety process rather than its paper counterpart reduces patient screening time and enables faster diagnosis and treatment, according to a study published in the December issue of Academic Radiology.

The time taken to complete inpatient MR exams was believed to increase the length of stay (LOS) in two hospital facilities by the study’s researchers, and filling out paper forms on MR safety was thought to contribute to this issue.

“The desire to improve safety with a patient-level overview of implant, medical, and surgical history motivated imbedding the MR safety screening process into the computerized physician order entry (CPOE) and requiring completion before placing the MR exam order,” wrote the study’s lead author, Erika Schneider, PhD, of the Cleveland Clinic, and colleagues.

Schneider and colleagues thus created a study to observe the impact of replacing the paper safety screening method with an electronic one on inpatient environment.

The electronic safety screening process is comprised of five parts: contraindicated medical devices, implanted devices that can undergo an MR exam under certain circumstances and risk factors for a contrast agent reaction, information needed by the MR technician or radiology nurse, patient-level health summary, and a verification/validation section for the ordering provider and radiology MR team.

Four months of inpatient MR exam orders and radiology reports completed before and after the implementation of the electronic process were retrospectively evaluated in the study. The gathered data were analyzed for time from order to MR exam completion, time from MR exam completion to final radiology report, LOS, and date of service within the admission.

The researchers evaluated 1, 947 individual MR orders for 1, 549 patients. The installation of the electronic safety screening process resulted in a 1.1 hour decrease in the mean time between first order and final report. A one-day time reduction occurred from admission to the MR exam in comparison to the paper process. No significant differences in time were seen for LOS, except in neurological intensive care patients screened within the first 24 hours of their admission, resulting in a 0.9 day decrease.

“Imbedding the MR safety screening in the inpatient CPOE process resulted in quicker data submission, expedited exams, and decreased ICU and hospital LOS,” wrote the study’s authors. “This process also has the potential advantage of providing safer MR exams by crossing encounters to include outpatient visits and inpatient visits at other facilities in the health care system.”