Targeting Missed Care Opportunities Using Modern Communication Methods: A Quality Improvement Initiative to Improve Access to CT and MRI Appointments
| Autor: | Matthew S. Davenport, Molly E Roseland, Glenn E. Houck, Prasad R. Shankar |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Quality management
medicine.diagnostic_test business.industry Reminder Systems Patient portal Magnetic resonance imaging Computed tomography Institutional review board medicine.disease Magnetic Resonance Imaging Quality Improvement Text message Appointments and Schedules Phone medicine Communication methods Humans Radiology Nuclear Medicine and imaging Prospective Studies Medical emergency Tomography X-Ray Computed business |
| Zdroj: | Academic Radiology. 29:395-401 |
| ISSN: | 1076-6332 |
| Popis: | To evaluate the impact of automated text and phone call reminder systems on CT (computed tomography) and MRI (magnetic resonance imaging) missed care opportunities.This was an IRB (institutional review board) exempt prospective interventional quality improvement study. The proportion of missed care opportunities (appointment made, no imaging performed) related to scheduled CT and MRI examinations were evaluated over 2 months (Month 1: reminder phone calls by staff 48-96 hours prior and mailed letter 1-2 weeks prior; Month 2: no manual call or letter, automated text message 24 hours prior, automated phone call 72 hours prior, automated patient portal message 7 days prior). The proportion of missed care opportunities was calculated in aggregate and by modality. Process control p-charts were generated. An a priori power analysis was performed. Chi-squared tests were performed. p-value0.017 was considered significant after Bonferroni correction.Missed care opportunities occurred for 2.82% (292/10348; 95% CI: 2.51-3.16) of all CT and MRI appointments using traditional communication and 2.44% (262/10719; 95% CI: 2.16-2.75) using automated communication (p = 0.09). Automated messaging did not significantly change the proportion of missed care opportunities for CT (traditional: 2.62% [95% CI: 2.23-3.06] vs. automated: 2.06% [95% CI: 1.70-2.48], p = 0.05) or MRI (traditional: 3.1% [95% CI: 2.60-3.66] vs. automated: 2.83% [95% CI: 2.40-3.30], p = 0.43). Process control p-charts showed dominance of common cause variation.Automated messaging did not meaningfully change the overall proportion of missed care opportunities compared to traditional human-initiated phone calls. Automated communications may reduce cost and improve efficiency without adversely affecting access to care. |
| Databáze: | OpenAIRE |
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