The Use of Medical Imaging Request Forms as Trigger Tools to Detect Intra-Hospital Adverse Events: A Pilot Study

To evaluate the contribution of medical imaging request forms as trigger tools to detect patient adverse event (AE) occurring during hospitalization.

This is a retrospective study in a single institution. Between January and June 2019, the hospital information system (HIS) was fetched for request forms of radiological examinations performed for inpatients >48 hours after the admission date. The investigated request forms were: Doppler ultrasound of the upper limbs, Doppler ultrasound of the lower limbs, and the repetition of three consecutive requests of chest radiographs within 24 hrs, to detect upper or lower limb venous thrombosis, or AEs related to the respiratory system, respectively. Patients' medical charts and radiological examinations were evaluated to document the presence or absence of an AE. The frequencies of AEs in the three groups of trigger tools were compared to corresponding control groups, matched according to age, sex and length of stay.

Among a total of 2798 hospital admissions during the study period, there were 74 files triggered by the three types of radiological request forms. There were 6/24 AE (25%) related to upper limb venous thrombosis, 4/33 (12.1%) AE related to lower limb venous thrombosis, and 6/17 (35.3%) AE related to the respiratory system. For all the trigger tools, the frequency of AE in the study groups was significantly higher than that in the control groups.

Medical imaging requests could be used as potential trigger tools to detect adverse events related to hospital stay.