Getting the timing right: An implementation study and pre post audit to implement evidence-based parathyroid scan...

Area of Science:

• Nuclear Medicine
• Implementation Science
• Healthcare Quality Improvement

Background:

• Clinical practice guidelines are crucial for healthcare providers but challenging to implement.
• Aligning nuclear medicine procedures with evidence-based recommendations requires effective strategies.
• This study addresses the gap between guideline recommendations and actual practice in parathyroid scintigraphy.

Purpose of the Study:

• To describe and evaluate an implementation strategy for aligning nuclear medicine practice with clinical guideline recommendations.
• To efficiently translate evidence into practice for parathyroid scintigraphy scan timing.
• To assess the impact of a combined implementation science and quality improvement approach.

Main Methods:

• A structured process using a modified A3 tool for improvement, integrating implementation science principles.
• Exploration of barriers to evidence translation and development of a targeted implementation strategy.
• Evaluation through a pre-post audit of routinely collected data on scan timing.

Main Results:

• Barriers identified included protocol misalignment, lack of technologist knowledge, scheduling issues, and physician resistance.
• Targeted strategies addressed capability (education), opportunity (policy updates), and motivation (feedback).
• Compliance with European Association of Nuclear Medicine guidelines for parathyroid scintigraphy timing improved from 18% to 98% (p < 0.01).

Conclusions:

• Successful implementation of updated European Association of Nuclear Medicine guidelines was achieved in a nuclear medicine department.
• A robust intervention combining continuous improvement, implementation science, and research methodology proved effective for evidence translation.
• This approach can be utilized to enhance other aspects of evidence-based practice in nuclear medicine.