Acute spinal cord compression: CQI framework increases resource efficiency while promoting delivery of high-quality...

Area of Science:

• Radiology
• Quality Improvement
• Health Services Research

Background:

• Advanced imaging, particularly in emergency settings, is frequently overutilized.
• Stat spinal MRI for suspected acute spinal cord compression (ASCC) was perceived as excessively used at the institution.

Purpose of the Study:

• To investigate the utilization trends of stat spinal MRI for suspected ASCC.
• To implement a continuous quality improvement process to enhance diagnostic efficiency.

Main Methods:

• Retrospective evaluation of spine imaging for ASCC appropriateness and quality.
• Implementation of a new institutional policy and screening MRI protocol.
• Analysis of indications, efficacy, and utilization of the new strategy.

Main Results:

• Initial study showed a low ASCC positive rate (1.4%) and image quality issues.
• New policy and protocol increased ASCC positive rate to 4.4%.
• Scan time decreased by 50-70% with preserved image quality and reduced resource use.

Conclusions:

• Stat spinal MRI for ASCC was indeed overutilized.
• Systemic improvements are achievable through multidisciplinary approaches and quality improvement.
• The new MRI protocol maintains diagnostic quality while reducing scan time and resource consumption.