Changing primary care requesting practices for MRI knee: A quality improvement project.

Area of Science:

• Radiology
• Healthcare Management
• Primary Care Medicine

Background:

• Knee MRI referrals from primary care are often inappropriate for patients over 45.
• Inefficient referral practices lead to increased healthcare costs and longer waiting lists.

Purpose of the Study:

• To analyze primary care MRI knee referral patterns in patients aged 45 and older.
• To develop and implement a new referral pathway to decrease inappropriate MRI knee requests.
• To evaluate the impact of the new pathway on referral rates and adherence to guidelines.

Main Methods:

• Retrospective analysis of primary care MRI knee referrals before and after pathway implementation.
• Development of a new referral pathway in collaboration with orthopaedic specialists and the Clinical Commissioning Group (CCG).
• Dissemination of the new pathway through the CCG resource webpage and local education.

Main Results:

• A 42% reduction in MRI knee acquisitions from primary care referrals was observed post-implementation.
• Adherence to the new guidelines was 67% among referring physicians.
• The proportion of patients undergoing MRI knee without a prior plain radiograph decreased from 47% to 20%.

Conclusions:

• The new referral pathway effectively reduced inappropriate MRI knee acquisitions in older symptomatic patients.
• The implemented changes align with Royal College of Radiology recommendations and have shortened outpatient waiting lists.
• Collaborative development with local CCGs is crucial for successful pathway implementation.