Bonmyong Lee1, Hansel J Otero2,3, Matthew T Whitehead4,5. 1. Department of Radiology, The Johns Hopkins Medical Institute, Baltimore, MD, USA. 2. Department of Radiology, Children's National Medical Center, 111 Michigan Ave. NW, Washington, DC, 20010, USA. 3. The George Washington University School of Medicine, Washington, DC, USA. 4. Department of Radiology, Children's National Medical Center, 111 Michigan Ave. NW, Washington, DC, 20010, USA. MWhitehe@childrensnational.org. 5. The George Washington University School of Medicine, Washington, DC, USA. MWhitehe@childrensnational.org.
Abstract
BACKGROUND: The American College of Radiology (ACR) practice parameters for communication dictate that follow-up recommendations be suggested when appropriate. Radiologists assume that referring physicians read their reports and heed their advice. In reality, recommendations might not be carried out or even acknowledged. OBJECTIVE: We aimed to determine the proportion of imaging recommendations that are acknowledged and acted upon. MATERIALS AND METHODS: We conducted a retrospective review of all consecutive radiology reports containing "recommend" in the impression at a single academic children's hospital over a 1-month period. We documented point of care (emergency department, inpatient, outpatient), study type, recommendation wording, and communication method (report only or direct verbal). We reviewed medical records to ascertain whether the recommendations were acknowledged or executed. We used chi-square tests to evaluate associations between variables. P<0.05 was considered significant. RESULTS: We reviewed 526 reports and excluded 73. We included the remaining 453 reports, from 370 unique patients (201 male, 169 female). Inpatients comprised most reports (n=223), followed by emergency department (ED) patients (n=118) and outpatients (n=112). Among these reports, 69% (n=313) of recommendations were executed. Of the 140 recommendations not carried out, 14% were acknowledged in clinical notes. Compliance correlated with point of care (ED>inpatient>outpatient; P=0.001) but not with additional verbal communication (P=0.33), study type (radiograph vs. other; P=0.35) or type of follow-up recommendation (follow-up imaging vs. other; P=0.99). CONCLUSION: Nearly one-third of radiology report follow-up recommendations are not executed. Recommendations are most commonly neglected for outpatient imaging reports. The radiology community should take steps to improve recommendation adherence.
BACKGROUND: The American College of Radiology (ACR) practice parameters for communication dictate that follow-up recommendations be suggested when appropriate. Radiologists assume that referring physicians read their reports and heed their advice. In reality, recommendations might not be carried out or even acknowledged. OBJECTIVE: We aimed to determine the proportion of imaging recommendations that are acknowledged and acted upon. MATERIALS AND METHODS: We conducted a retrospective review of all consecutive radiology reports containing "recommend" in the impression at a single academic children's hospital over a 1-month period. We documented point of care (emergency department, inpatient, outpatient), study type, recommendation wording, and communication method (report only or direct verbal). We reviewed medical records to ascertain whether the recommendations were acknowledged or executed. We used chi-square tests to evaluate associations between variables. P<0.05 was considered significant. RESULTS: We reviewed 526 reports and excluded 73. We included the remaining 453 reports, from 370 unique patients (201 male, 169 female). Inpatients comprised most reports (n=223), followed by emergency department (ED) patients (n=118) and outpatients (n=112). Among these reports, 69% (n=313) of recommendations were executed. Of the 140 recommendations not carried out, 14% were acknowledged in clinical notes. Compliance correlated with point of care (ED>inpatient>outpatient; P=0.001) but not with additional verbal communication (P=0.33), study type (radiograph vs. other; P=0.35) or type of follow-up recommendation (follow-up imaging vs. other; P=0.99). CONCLUSION: Nearly one-third of radiology report follow-up recommendations are not executed. Recommendations are most commonly neglected for outpatient imaging reports. The radiology community should take steps to improve recommendation adherence.
Authors: Susanna I Lee; Arun Krishnaraj; Manjil Chatterji; Keith J Dreyer; James H Thrall; Peter F Hahn Journal: Radiology Date: 2011-11-14 Impact factor: 11.105
Authors: Stacy K Goergen; Felicity J Pool; Tari J Turner; Jane E Grimm; Mark N Appleyard; Carmel Crock; Michael C Fahey; Michael F Fay; Nicholas J Ferris; Susan M Liew; Richard D Perry; Ann Revell; Grant M Russell; Shih-Chang S C Wang; Christian Wriedt Journal: J Med Imaging Radiat Oncol Date: 2012-12-28 Impact factor: 1.735
Authors: Claudia D Furtado; Diego A Aguirre; Claude B Sirlin; David Dang; Stephan K Stamato; Patrick Lee; Farhad Sani; Michelle A Brown; David L Levin; Giovanna Casola Journal: Radiology Date: 2005-09-16 Impact factor: 11.105
Authors: Teerath P Tanpitukpongse; Allen T Grady; Julie A Sosa; James D Eastwood; Kingshuk R Choudhury; Jenny K Hoang Journal: AJR Am J Roentgenol Date: 2015-12 Impact factor: 3.959
Authors: Savvas Andronikou; Hansel J Otero; Sabine Belard; Charlotte Carina Heuvelings; Lisa C Ruby; Martin Peter Grobusch Journal: Pediatr Radiol Date: 2021-09-24