Neuroimaging in a memory assessment service: a completed audit cycle

Area of Science:

• Neurology
• Radiology
• Healthcare Management

Background:

• Memory assessment services are crucial for diagnosing cognitive decline.
• Standardized neuroimaging protocols are needed to ensure consistent patient care.
• Existing guidelines require adaptation to local resource availability.

Purpose of the Study:

• To evaluate the impact of implementing adapted evidence-based guidelines on neuroimaging practices in a memory assessment service.
• To compare neuroimaging utilization and efficiency before and after guideline implementation.
• To assess changes in waiting times and practice variations.

Main Methods:

• A clinical audit was conducted before and 6 months after guideline implementation.
• Multislice computed tomography (CT) was established as the first-line structural imaging procedure.
• Data on referrals, imaging rates, documented reasons for no imaging, and waiting times were collected and compared.

Main Results:

• Referrals to the service nearly doubled.
• The proportion of patients receiving at least one neuroimaging procedure increased from 68% to 76%.
• The percentage of patients with no documented reason for not having imaging decreased from 50% to less than 1%.
• Mean waiting times for scans increased only slightly from 22 to 30 days.
• Practice variations between sectors were reduced.

Conclusions:

• Disseminating adapted, evidence-based guidelines can standardize neuroimaging practices in memory assessment services.
• The implemented guidelines improved imaging consistency and reduced undocumented non-imaging decisions.
• Further research is planned to investigate the clinical and cost benefits of increased scanning.