Thomas M Dykes1, Mythreyi Bhargavan-Chatfield2, Raymond B Dyer3. 1. Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address: tdykes@hmc.psu.edu. 2. ACR, Reston, Virginia. 3. Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Abstract
PURPOSE: Establish 3 performance benchmarks for intravenous contrast extravasation during CT examinations: extravasation frequency, distribution of extravasation volumes, and severity of injury. Evaluate the effectiveness of implementing practice quality improvement (PQI) methodology in improving performance for these 3 benchmarks. METHODS: The Society of Abdominal Radiology and ACR developed a registry collecting data for contrast extravasation events. The project includes a PQI initiative allowing for process improvement. RESULTS: As of December 2013, a total of 58 radiology practices have participated in this project, and 32 practices have completed the 2-cycle PQI. There were a total of 454,497 contrast-enhanced CT exams and 1,085 extravasation events. The average extravasation rate is 0.24%. The median extravasation rate is 0.21%. Most extravasations (82.9%) were between 10 mL and 99 mL. The majority of injuries, 94.6%, are mild in severity, with 4.7% having moderate and 0.8% having severe injuries. Data from practices that completed the PQI process showed a change in the average extravasation rate from 0.28% in the first 6 months to 0.23% in the second 6 months, and the median extravasation rate dropped from 0.25% to 0.16%, neither statistically significant. The distribution of extravasation volumes and the severity of injury did not change between the first and second measurement periods. CONCLUSIONS: National performance benchmarks for contrast extravasation rate, distribution of volumes of extravasate, and distribution of severity of injury are established through this multi-institutional practice registry. The application of PQI failed to have a statistically significant positive impact on any of the 3 benchmarks.
PURPOSE: Establish 3 performance benchmarks for intravenous contrast extravasation during CT examinations: extravasation frequency, distribution of extravasation volumes, and severity of injury. Evaluate the effectiveness of implementing practice quality improvement (PQI) methodology in improving performance for these 3 benchmarks. METHODS: The Society of Abdominal Radiology and ACR developed a registry collecting data for contrast extravasation events. The project includes a PQI initiative allowing for process improvement. RESULTS: As of December 2013, a total of 58 radiology practices have participated in this project, and 32 practices have completed the 2-cycle PQI. There were a total of 454,497 contrast-enhanced CT exams and 1,085 extravasation events. The average extravasation rate is 0.24%. The median extravasation rate is 0.21%. Most extravasations (82.9%) were between 10 mL and 99 mL. The majority of injuries, 94.6%, are mild in severity, with 4.7% having moderate and 0.8% having severe injuries. Data from practices that completed the PQI process showed a change in the average extravasation rate from 0.28% in the first 6 months to 0.23% in the second 6 months, and the median extravasation rate dropped from 0.25% to 0.16%, neither statistically significant. The distribution of extravasation volumes and the severity of injury did not change between the first and second measurement periods. CONCLUSIONS: National performance benchmarks for contrast extravasation rate, distribution of volumes of extravasate, and distribution of severity of injury are established through this multi-institutional practice registry. The application of PQI failed to have a statistically significant positive impact on any of the 3 benchmarks.
Authors: Júlia Karády; Alexisz Panajotu; Márton Kolossváry; Bálint Szilveszter; Ádám L Jermendy; Andrea Bartykowszki; Mihály Károlyi; Csilla Celeng; Béla Merkely; Pál Maurovich-Horvat Journal: Eur Radiol Date: 2017-05-24 Impact factor: 5.315
Authors: Terence Z Wong; Thad Benefield; Shane Masters; Jackson W Kiser; James Crowley; Dustin Osborne; Osama Mawlawi; James Barnwell; Pawan Gupta; Akiva Mintz; Kelley A Ryan; Steven R Perrin; Ronald K Lattanze; David W Townsend Journal: J Nucl Med Technol Date: 2019-06-10