Changing primary care requesting practices for MRI knee: A quality improvement project.

Autor: Robinson E; FRCR, North Bristol NHS Trust, UK. Electronic address: Elizabeth.robinson@doctors.org.uk., Rajayogeswaran B; FRCR, North Bristol NHS Trust, UK., Walton E; FRCR, North Bristol NHS Trust, UK.
Jazyk: angličtina
Zdroj: Radiography (London, England : 1995) [Radiography (Lond)] 2023 May; Vol. 29 (3), pp. 519-525. Date of Electronic Publication: 2023 Mar 10.
DOI: 10.1016/j.radi.2023.02.026
Abstrakt: Objectives: The objectives of this work were first to examine referral practices from primary care for MRI knee in patients ≥45 years old and then to develop a new referral pathway to reduce the number of inappropriate MRI knee referrals. Following this, the aim was to re-assess the effect of the intervention and identify further areas for improvement.
Methods: A baseline retrospective analysis of knee MRIs requested from primary care in symptomatic patients ≥45years over a two-month period was undertaken. A new referral pathway was implemented in consensus with orthopaedic specialists and the clinical commissioning group (CCG), via the CCG resource webpage and local education. Following implementation, a repeat data analysis was undertaken.
Results: The number of MRI knees acquired from primary care referrals reduced by 42% after the new pathway was implemented. 67% (46/69) were compliant with the new guidelines. The number of patients having an MRI knee without a prior plain radiograph was 14/69 (20%) compared to 55/118 (47%) prior the pathway changes.
Conclusion: The new referral pathway reduced the number of knee MRI acquisitions in primary care patients ≥45 years by 42%. Changing the pathway has decreased the number of patients undergoing MRI knee without a prior radiograph from 47% to 20%. These outcomes bring our standards towards the evidence-based recommendations of the Royal College of Radiology and have reduced our outpatient waiting list for MRI knee.
Implications for Practice: Implementing a new referral pathway with the local CCG can successfully reduce the number of inappropriate MRI knee acquisitions from primary care referrals in older symptomatic patients.
Competing Interests: Conflict of interest The authors have no conflicts of interest to declare.
(Copyright © 2023 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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