减少鼻骨折不必要的X射线:一个质量改进项目
Jess Rhee1, Danielle Kelton2, Sheena Belisle3
1Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, London, ON, Canada.
概括
使用临床决策支持工具和教育,鼻骨X射线用于鼻骨折的X射线显著减少了73%. 这项质量改进计划降低了成本和环境影响,而不会增加CT扫描.
科学领域:
- 放射学 放射学是一门学科.
- 提高质量 提高质量
- 医疗保健管理的管理
背景情况:
- 选择明智加拿大建议不要进行鼻骨X射线,以评估鼻骨折.
- 鼻骨X射线经常被过度利用来诊断鼻骨折.
- 减少不必要的成像与基于证据的实践和资源管理相一致.
研究的目的:
- 在一年内将鼻骨X射线的数量减少50%.
- 评估质量改进计划对成像利用的影响.
- 评估减少X射线使用的成本节约和环境效益.
主要方法:
- 使用了卫生保健改进研究所的改进模型.
- 实施了干预前后的研究,包括临床决策支持工具和提供者教育.
- 监控月度X射线订单,评估财务成本,并推断出环境影响 (CO2e).
主要成果:
- 在订购的鼻骨X射线中实现了73%的减少 (197到58).
- 显示出一个统计学上显著的平均每月减少53% (4.9到2.3X射线/月).
- 报告节省了5534.98美元的成本,减少了111.2公斤的CO2e环境足迹,但CT扫描的数量没有增加.
结论:
- 临床决策支持工具和有针对性的教育有效地减少了不必要的鼻骨X射线.
- 这项质量改进项目成功减少了患者调查,医疗保健成本和环境影响.
- 该倡议支持"明智选择加拿大"的建议,并促进对诊断成像的明智使用.
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