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Extension of academic pediatric radiology to the community setting: experience in two sites
1Department of Radiology, Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Insights
Community-based pediatric imaging programs improved access and satisfaction for children. Academic pediatric radiologists enhanced diagnostic information and image quality in underserved areas.
Area of Science:
- Pediatric Radiology
- Healthcare Access
- Community Health
Background:
- Children require specialized care from trained pediatric radiologists and staff.
- Access to dedicated pediatric imaging facilities can be limited by various obstacles.
Purpose of the Study:
- To design and implement community-based pediatric imaging models.
- To improve access to specialized pediatric imaging services.
Main Methods:
- Established two models: an outpatient clinic and a community hospital radiology department.
- Involved university-affiliated children's hospital radiologists and group practice.
- Required modifications to facilities, equipment, and protocols for quality assurance.
Main Results:
- Significant increases in pediatric examinations at both sites (48-87% and over 1000%).
- Improved diagnostic information and patient satisfaction reported by referring physicians.
- Enhanced image quality observed with pediatric radiologist presence, though off-hours challenges persisted.
Conclusions:
- Successfully implemented pediatric imaging programs in underserved communities.
- Increased pediatric radiologist supervision and interpretation of pediatric examinations.
- Improved referring physician and patient satisfaction with imaging services.
Background:
Children are better served by radiologists and technical personnel trained in the care of pediatric patients. However, a variety of obstacles may limit the access of children to dedicated pediatric imaging facilities.
Objective:
We designed and implemented two models for providing community-based imaging by academic pediatric radiologists.
Materials:
and methods. The first site was an outpatient clinic staffed by physicians from the university-affiliated children's hospital. Imaging services included radiography, fluoroscopy, and ultrasound. The second site was a full-service community hospital radiology department staffed by a group practice, with pediatric imaging covered by the children's hospital radiologists. Facility, equipment, and protocol modifications were required to maintain quality standards. Success of these models was determined by volume statistics, referring physician/patient satisfaction surveys, and quality-assurance (QA) programs.
Results:
The outpatient satellite had a 48 % increase in total examinations from the first year to the second year and 87 % the third year. Pediatric examinations in the community hospital increased over 1000 % the first 7 months. Referring physicians reported increased diagnostic information and patient satisfaction compared to previous service. QA efforts revealed improved image quality when pediatric radiologists were present, but some continuing difficulties off-hours.
Conclusion:
We successfully implemented pediatric imaging programs in previously underserved communities. This resulted in increased pediatric radiologist supervision and interpretation of examinations performed on children and improved referring physician and patient satisfaction.