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Protecting trauma patients from duplicated computed tomography scans: the relevance of integrated care systems
Amy E Liepert1, Joseph Bledsoe2, Mark H Stevens3
1Department of Surgery, University of Wisconsin, Madison, WI, USA.
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.
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