Marla B K Sammer1,2, Marcus D Sammer3, Lane F Donnelly4,5. 1. Department of Radiology, Texas Children's Hospital, 6107 Fannin St., Suite 470, Houston, TX, 77030, USA. mbsammer@texaschildrens.org. 2. Department of Radiology, Baylor College of Medicine, Houston, TX, USA. mbsammer@texaschildrens.org. 3. Department of Radiology, Baylor College of Medicine, Houston, TX, USA. 4. Center for Pediatric and Maternal Value, Lucile Packard Children's Hospital at Stanford, Palo Alto, CA, USA. 5. Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA.
Abstract
BACKGROUND: Common cause analysis of learning opportunities identified in a peer collaborative improvement process can gauge the potential risk to patients and opportunities to improve. OBJECTIVE: To study rates of learning opportunities based on radiologist assignment, patient type and exam priority at an academic children's hospital with 24/7 in-house attending coverage. MATERIALS AND METHODS: Actively submitted peer collaborative improvement learning opportunities from July 2, 2016, to July 31, 2018, were identified. Learning opportunity rates (number of learning opportunities divided by number of exams in each category) were calculated based on the following variables: radiologist assignment at the time of dictation (daytime weekday, daytime weekend and holiday, evening, and night) patient type (inpatient, outpatient or emergency center) and exam priority (stat, urgent or routine). A statistical analysis of rate differences was performed using a chi-square test. Pairwise comparisons were made with Bonferroni method adjusted P-values. RESULTS: There were 1,370 learning opportunities submitted on 559,584 studies (overall rate: 0.25%). The differences in rates by assignment were statistically significant (P<0.0001), with the highest rates on exams dictated in the evenings (0.31%) and lowest on those on nights (0.19%). Weekend and holiday daytime (0.26%) and weekday daytime (0.24%) rates fell in between. There were significantly higher rates on inpatients (0.33%) than on outpatients (0.22%, P<0.0001) or emergency center patients (0.16%, P<0.0001). There were no significant differences based on exam priority (stat 0.24%, urgent 0.26% and routine 0.24%, P=0.55). CONCLUSION: In this study, the highest learning opportunity rates occurred on the evening rotation and inpatient studies, which could indicate an increased risk for patient harm and potential opportunities for improvement.
BACKGROUND: Common cause analysis of learning opportunities identified in a peer collaborative improvement process can gauge the potential risk to patients and opportunities to improve. OBJECTIVE: To study rates of learning opportunities based on radiologist assignment, patient type and exam priority at an academic children's hospital with 24/7 in-house attending coverage. MATERIALS AND METHODS: Actively submitted peer collaborative improvement learning opportunities from July 2, 2016, to July 31, 2018, were identified. Learning opportunity rates (number of learning opportunities divided by number of exams in each category) were calculated based on the following variables: radiologist assignment at the time of dictation (daytime weekday, daytime weekend and holiday, evening, and night) patient type (inpatient, outpatient or emergency center) and exam priority (stat, urgent or routine). A statistical analysis of rate differences was performed using a chi-square test. Pairwise comparisons were made with Bonferroni method adjusted P-values. RESULTS: There were 1,370 learning opportunities submitted on 559,584 studies (overall rate: 0.25%). The differences in rates by assignment were statistically significant (P<0.0001), with the highest rates on exams dictated in the evenings (0.31%) and lowest on those on nights (0.19%). Weekend and holiday daytime (0.26%) and weekday daytime (0.24%) rates fell in between. There were significantly higher rates on inpatients (0.33%) than on outpatients (0.22%, P<0.0001) or emergency center patients (0.16%, P<0.0001). There were no significant differences based on exam priority (stat 0.24%, urgent 0.26% and routine 0.24%, P=0.55). CONCLUSION: In this study, the highest learning opportunity rates occurred on the evening rotation and inpatient studies, which could indicate an increased risk for patient harm and potential opportunities for improvement.
Authors: Tarek N Hanna; Christine Lamoureux; Elizabeth A Krupinski; Scott Weber; Jamlik-Omari Johnson Journal: Radiology Date: 2017-11-20 Impact factor: 11.105
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Authors: Christy I Sandborg; Gary E Hartman; Felice Su; Glyn Williams; Beate Teufe; Nina Wixson; David B Larson; Lane F Donnelly Journal: Pediatr Qual Saf Date: 2020-12-28