Amy E Liepert1, Joseph Bledsoe2, Mark H Stevens3, Amalia Cochran4. 1. Department of Surgery, University of Wisconsin, Madison, WI, USA. Electronic address: liepert@surgery.wisc.edu. 2. Department of Emergency Medicine, Murray, UT, USA. 3. Department of Surgery, Intermountain Medical Center, Murray, UT, USA. 4. Department of Surgery, University of Utah, Salt Lake City, UT, USA.
Abstract
BACKGROUND: Duplicated computed tomography (CT) scans in transferred trauma patients have been described in university-based trauma systems. This study compares CT utilization between a university-based nonintegrated system (NIS) and a vertically integrated regional healthcare system (IS). METHODS: Trauma patients transferred to 2 Level I trauma centers were prospectively identified at the time of transfer. Imaging obtained before and subsequent to transfer and the reason for CT imaging at the Level I center were captured by real-time reporting. RESULTS: Four hundred eighty-one patients were reviewed (207 at NIS and 274 at IS). Ninety-nine patients (48%) at NIS and 45 (16%) at IS underwent duplicate scanning of at least one body region. Inadequate scan quality and incomplete imaging were the most common reason category reported at NIS (54%) and IS (78%). CONCLUSIONS: Fewer patients received duplicated scans within the vertically IS as compared with a traditional university-based referral system. Our findings suggest that the adoption of features of a vertically IS, particularly improved transferability of radiographic studies, may improve patient care in other system types.
BACKGROUND: Duplicated computed tomography (CT) scans in transferred traumapatients have been described in university-based trauma systems. This study compares CT utilization between a university-based nonintegrated system (NIS) and a vertically integrated regional healthcare system (IS). METHODS:Traumapatients transferred to 2 Level I trauma centers were prospectively identified at the time of transfer. Imaging obtained before and subsequent to transfer and the reason for CT imaging at the Level I center were captured by real-time reporting. RESULTS: Four hundred eighty-one patients were reviewed (207 at NIS and 274 at IS). Ninety-nine patients (48%) at NIS and 45 (16%) at IS underwent duplicate scanning of at least one body region. Inadequate scan quality and incomplete imaging were the most common reason category reported at NIS (54%) and IS (78%). CONCLUSIONS: Fewer patients received duplicated scans within the vertically IS as compared with a traditional university-based referral system. Our findings suggest that the adoption of features of a vertically IS, particularly improved transferability of radiographic studies, may improve patient care in other system types.
Authors: Monica Tung; Ritu Sharma; Jeremiah S Hinson; Stephanie Nothelle; Jean Pannikottu; Jodi B Segal Journal: Am J Emerg Med Date: 2017-10-25 Impact factor: 2.469