Simple quality improvement measures reduce problematic CT overuse for liver imaging
Educational interventions and national guidelines can help temper excessive orders for abdominal CT scans, which are commonly overused for imaging the liver.
Overutilization of CT exams has both clinical and financial ramifications, impacting patient radiation doses, clinical workflow, overhead and insurance reimbursement rates.
The Centers for Medicare & Medicaid Services tracks the use of abdominopelvic CT scans with and without contrast as a measure of quality. And after Loma Linda University Medical Center was found to be overutilizing these imaging exams, researchers at the California institution implemented various quality improvement measures to resolve the issue.
"Using appropriate imaging protocols can improve the quality of images obtained with minimizing/optimizing radiation exposure to patients due to acquisition of unnecessary non-contrast images," corresponding author Natalie Albasha, with the University of California, Riverside School of Medicine, and co-authors explained.
As part of the quality improvement measures at the facility, the current ACR LI-RADS were reviewed with diagnostic and interventional radiologists, CT managers and technologists. This led the team to identify which protocols were not in line with the ACR guidelines and pushed them to update those protocols to reflect the current standards. Afterwards, the facility conducted an educational session with technologists and stakeholders explaining the changes, and the protocols were updated on all CT scanners.
The intervention resulted in a decrease in the median monthly number of abdominopelvic CTs with and without contrast, dropping to 53 from 74. Conversely, the number of abdominopelvic scans with contrast increased to 37.5 from 11.
“One of the key highlights of our project was the importance of establishing a relationship between the liver transplant team, the hospital, and the radiology department to achieve a shared goal to meet national benchmarks,” the experts wrote. “Our quality improvement effort to reduce overutilization demonstrates the value of national quality metrics and guidelines for reevaluating our radiology practice and protocols, and the impact radiology-led efforts can have to reduce overutilization of imaging services.”
You can view the detailed research in Current Problems in Diagnostic Radiology.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.