Utilizing Process Improvement Methodology to Improve Inpatient Access to MRI

Drose, Julia A.; Pritchard, N.; Honce, Justin M.; Snuttjer, Denise K.; Borgstede, James P.

doi:10.1148/rg.2019190043

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…Accounting for the time from when a physician places an imaging order until the results are obtained can take up 8 hours ( Table 1 ) according to interviews conducted by the author with ICU and radiology staff. There is a wide variation in these cycle times from hospital to hospital and institution to institution, where one study found the average turnaround time from placement of the imaging request to initiation of an MRI scan to be 751 minutes (∼12.5 hours) [ 17 ] and with some institutions reporting times from MRI order to result of more than 24 hours. For example, a study by Tiwari et al [ 18 ] suggests that the average waiting time for an inpatient with suspected occult femoral neck fracture for an MRI scan is 23 hours.…”

Section: The Problem Todaymentioning

confidence: 99%

“…The wait time for the study or procedure has also been identified as a factor that increases the risk of mishaps during transport [ 19 ]. Depending on the exam that is ordered and wait times or delays once arriving at the MRI suite [ 17 , 18 , 20 ], there may be a longer time required for the transport team to be away from their normally assigned positions complicated by the time that the patient is away from therapy and the standard ICU environment. A consideration for ICU managers is whether to backfill for the staff that are part of the transport team.…”

Section: The Problem Todaymentioning

confidence: 99%

“…As described earlier, hospitals have a wide range of turnaround times for ICU MRI results. Even in the best-case scenario, the logistical and clinical challenges of finding an available high-field MRI schedule slot and moving patients from the ICU to the MRI suite and back add at least several hours, and in some cases, more than 24 hours is needed before MRI results become available [ 17 ]. Diagnostic delays due to staff shortages, radiology process issues, equipment errors, patient-related rescheduling, and equipment availability are cited as a growing cause of medical negligence claims [ 45 ].…”

Section: The Problem Todaymentioning

confidence: 99%

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MRI and the Critical Care Patient: Clinical, Operational, and Financial Challenges

McLean

Thompson

2023

Critical Care Research and Practice

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Neuroimaging in conjunction with a neurologic examination has become a valuable resource for today’s intensive care unit (ICU) physicians. Imaging provides critical information during the assessment and ongoing neuromonitoring of patients for toxic-metabolic or structural injury of the brain. A patient’s condition can change rapidly, and interventions may require imaging. When making this determination, the benefit must be weighed against possible risks associated with intrahospital transport. The patient’s condition is assessed to decide if they are stable enough to leave the ICU for an extended period. Intrahospital transport risks include adverse events related to the physical nature of the transport, the change in the environment, or relocating equipment used to monitor the patient. Adverse events can be categorized as minor (e.g., clinical decompensation) or major (e.g., requiring immediate intervention) and may occur in preparation or during transport. Regardless of the type of event experienced, any intervention during transport impacts the patient and may lead to delayed treatment and disruption of critical care. This review summarizes the commentary on the current literature on the associated risks and provides insight into the costs as well as provider experiences. Approximately, one-third of patients who are transported from the ICU to an imaging suite may experience an adverse event. This creates an additional risk for extending a patient’s stay in the ICU. The delay in obtaining imaging can negatively impact the patient’s treatment plan and affect long-term outcomes as increased disability or mortality. Disruption of ICU therapy can decrease respiratory function after the patient returns from transport. Because of the complex care team needed for patient transport, the staff time alone can cost $200 or more. New technologies and advancements are needed to reduce patient risk and improve safety.

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Section: The Problem Todaymentioning

confidence: 99%

Section: The Problem Todaymentioning

confidence: 99%

Section: The Problem Todaymentioning

confidence: 99%

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MRI and the Critical Care Patient: Clinical, Operational, and Financial Challenges

McLean

Thompson

2023

Critical Care Research and Practice

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“…The transport of critical care patients poses additional challenges, as adverse events occur in up to 70% [5][6][7][8]. Significant delays between MRI order and exam completion are associated with increased hospital length of stay (LOS) and cost [9,10]. Cheng et al observed that MRI access was a predictor for failure to meet established LOS targets (odds ratio 19.33) and was significantly higher than computed tomography (CT) or ultrasound [11].…”

Section: Introductionmentioning

confidence: 99%

MRI at the Bedside: A Case Report Comparing Fixed and Portable Magnetic Resonance Imaging for Suspected Stroke

Hovis

Langdorf

Dang

et al. 2021

Cureus

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Magnetic resonance imaging (MRI) provides high-contrast resolution and is the preferred diagnostic tool for neurological disease. However, long exam times discourage MRI in emergency settings, and high-field MRI scanners (1.5-3T) require dedicated imaging suites. New, portable low-field-strength MRI machines (0.064T) have lower resolution than fixed MRI, but do not require restrictive environments or intrahospital transport. We present a case of a 78-year-old male with altered mental status who underwent 0.064T portable MRI and fixed 3T MRI exams in the emergency department. Imaging showed no evidence of acute infarction or intracranial lesions. The 0.064T images were of poor quality relative to 3T sequences, but the results of the portable MRI agreed with the conventional 3T MRI and a computed tomography scan from the same day. The compatible imaging results suggest that portable, low-field MRI can aid in neurological diagnosis without transporting patients to the MRI suite. Further studies should expand this comparison between high- and low-field MRI to better characterize the role and clinical applications of point-of-care MRI.

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Modern acceleration in musculoskeletal MRI: applications, implications, and challenges

Vosshenrich,

Koerzdoerfer,

Fritz

2024

Skeletal Radiol

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Utilizing Process Improvement Methodology to Improve Inpatient Access to MRI

Cited by 8 publications

References 10 publications

MRI and the Critical Care Patient: Clinical, Operational, and Financial Challenges

MRI and the Critical Care Patient: Clinical, Operational, and Financial Challenges

MRI at the Bedside: A Case Report Comparing Fixed and Portable Magnetic Resonance Imaging for Suspected Stroke

Modern acceleration in musculoskeletal MRI: applications, implications, and challenges

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