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Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports
Camilo Jaimes1, Diana J Murcia2, Karen Miguel3
1Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Background:
Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population.
Objective:
To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors.
Materials And Methods:
In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015. The safety report database was queried for events matching the same demographic and dates. Data on patient age, gender, location (inpatient, outpatient, emergency room [ER]), and the use of sedation/general anesthesia were recorded. Safety reports were grouped into categories based on the cause and their severity. Descriptive statistics were used to summarize continuous variables. Chi-square analyses were performed for univariate determination of statistical significance of variables associated with safety report rates. A multivariate logistic regression was used to control for possible confounding effects.
Results:
A total of 16,749 pediatric MRI studies and 88 safety reports were analyzed, yielding a rate of 0.52%. There were significant differences in the rate of safety reports between patients younger than 6 years (0.89%) and those older (0.41%) (P<0.01), sedated (0.8%) and awake children (0.45%) (P<0.01), and inpatients (1.1%) and outpatients (0.4%) (P<0.01). The use of sedation/general anesthesia is an independent risk factor for a safety report (P=0.02). The most common causes for safety reports were service coordination (34%), drug reactions (19%), and diagnostic test and ordering errors (11%).
Conclusion:
The overall rate of safety reports in pediatric MRI is 0.52%. Interventions should focus on vulnerable populations, such as younger patients, those requiring sedation, and those in need of acute medical attention.
Insights
Pediatric MRI safety reports occurred at 0.52%, with higher rates in younger, sedated, and inpatient children. Sedation is an independent risk factor, highlighting the need for targeted safety interventions.
Area of Science:
- Radiology
- Pediatric Imaging
- Patient Safety
Background:
- Analysis of adult magnetic resonance imaging (MRI) safety reports informs practice improvements.
- Pediatric MRI data is crucial for identifying specific areas for enhancement in this population.
Purpose of the Study:
- To determine the incidence of safety reports in pediatric MRI.
- To identify risk factors associated with safety events in pediatric MRI.
Main Methods:
- Retrospective analysis of 16,749 pediatric MRI studies (2010-2015) and associated safety reports.
- Data collected included patient demographics, location, and sedation status.
- Statistical analyses (chi-square, logistic regression) identified significant risk factors.
Main Results:
- The overall pediatric MRI safety report rate was 0.52%.
- Higher rates were observed in younger children (<6 years), sedated patients, and inpatients.
- Sedation/general anesthesia was an independent risk factor (P=0.02).
- Common causes included service coordination, drug reactions, and ordering errors.
Conclusions:
- The incidence of safety reports in pediatric MRI is 0.52%.
- Interventions should prioritize vulnerable groups: young children, those needing sedation, and acute care patients.
- Targeted safety improvements are needed for pediatric MRI.
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