SHM Converge Scientific Abstract ePoster Gallery-Improving Inpatient Cardiac Mri Stewardship via Multidisciplinary Team Approach

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This project addressed unusually high inpatient cardiac MRI (cMRI) use at a tertiary academic hospital, where utilization was far above peers. A multidisciplinary team from cardiology, radiology, hospital medicine, and hospital leadership created a stewardship intervention to ensure cMRI was performed inpatient only when clinically necessary.<br /><br />The intervention had three parts:  <br />1. Clear inpatient cMRI ordering criteria were established, limiting inpatient scans to specific high-acuity situations such as infiltrative cardiomyopathy with complete heart block or ventricular tachycardia, acute myocarditis, and viability assessment before urgent revascularization.  <br />2. Radiology acted as a gatekeeper for inpatient cMRI orders and reviewed cases that did not clearly meet criteria.  <br />3. Concierge outpatient scheduling was introduced to move non-urgent cMRIs to the ambulatory setting, ideally within two weeks after discharge.<br /><br />Using Vizient data, the team compared cMRI use before and after implementation. Inpatient cMRI ordering fell from an average of 39 per quarter to 17 per quarter, and all post-intervention inpatient scans met the new criteria. Outpatient cMRI increased by about 19 scans per month. The shift to outpatient imaging reduced length of stay by 0.5 day per patient for whom cMRI was deferred to outpatient care.<br /><br />Financially, the project saved an estimated $75,000 annually in inpatient cost avoidance and generated an additional $266,000 annually from outpatient imaging, for a total estimated annual impact of $341,000.<br /><br />Overall, the study shows that clear imaging criteria, radiology partnership, and improved outpatient access can reduce unnecessary inpatient resource use, shorten hospital stays, and improve financial performance.

Asset Subtitle

Alya Ahsan

Meta Tag

Author List Alya Ahsan, Amit Pursnani, Elizabeth Thorn, John Hollingsworth, Maureen Kharasch

Category Research

Concept Cardiac MRI Stewardship

Concept Inpatient Cardiac MRI

Concept Multidisciplinary Team

Concept Decision Criteria

Concept Evidence-Based Clinical Indication

Distinguished Non-Finalist

Presenter Organization Endeavor Health

Presenting Author Alya Ahsan

Track Quality Improvement

Keywords

cardiac MRI

inpatient utilization

imaging stewardship

radiology gatekeeper

ordering criteria

outpatient scheduling

length of stay reduction

resource utilization

cost savings

tertiary academic hospital

Cardiac MRI Stewardship

Inpatient Cardiac MRI

Multidisciplinary Team

Decision Criteria

Evidence-Based Clinical Indication