SHM Converge Scientific Abstract ePoster Gallery-Defining Imaging Priority Categories Decreases Number of Stat Orders and Time From Image Order to Completion Across Multiple Radiologic Modalities

Defining Imaging Priority Categories Decreases Number of Stat Orders and Time From Image Order to Completion Across Multiple Radiologic Modalities

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This quality improvement project addressed overuse of STAT imaging orders, which are intended for medical emergencies but were frequently applied to non-emergent cases. At the institution, 45% of all imaging exams were initially ordered STAT. A prior initiative in 2023 redefined imaging priorities as STAT for true emergencies, ASAP for urgent cases, and Routine for investigative studies. In a CT head pilot, the percentage of STAT orders dropped from 68% to 47%, and median STAT turnaround time improved by one hour.<br /><br />Building on that success, the team expanded the intervention to additional modalities, including CT head, CT chest, MRI brain, and MRI spine. A multidisciplinary team used Qlik dashboards to identify high-volume, high-STAT modalities and track performance. Process mapping revealed delays in MRI workflows, especially around screening and pacemaker forms, which were then improved. The electronic medical record order system was redesigned to begin with a STAT attestation; providers had to confirm emergency criteria before STAT would autofill, otherwise the order defaulted to Routine. Providers were also educated about the new priority definitions.<br /><br />After implementation, STAT ordering decreased across all studied modalities: CT head from 68% to 47%, CT chest from 43% to 23%, MRI brain from 70% to 60%, and MRI spine from 60% to 51%. Median turnaround times improved by 0.25 to 1 hour depending on the modality, with CT head improving by 48 minutes. The ASAP category was well adopted, with over 1,600 orders placed overall, and median ASAP turnaround time met the target at 3 hours.<br /><br />Overall, clarifying imaging priority categories and adding an ASAP option improved appropriateness of STAT use and reduced imaging delays.

Asset Subtitle

Colleen McIntosh

Meta Tag

Author List Colleen McIntosh, Denise R. Vander Werf, Keith Aldahondo, Rajendra Kedar, Sandra Genao

Category Innovations

Concept Imaging Priority Categories

Concept STAT Imaging Orders

Concept Imaging Order Accuracy

Concept Multidisciplinary Intervention

Concept Turnaround Time

Distinguished Non-Finalist

Presenter Organization University of South Florida

Presenting Author Colleen McIntosh

Track Quality Improvement

Keywords

STAT imaging

quality improvement

imaging orders

turnaround time

CT head

MRI brain

MRI spine

ASAP orders

electronic medical record

workflow optimization

Imaging Priority Categories

STAT Imaging Orders

Imaging Order Accuracy

Multidisciplinary Intervention

Turnaround Time