High Scan Volume with Low Positive Scan Rate in Highest Utilizers: Computed Tomography Pulmonary Angiography in the Emergency Department
| Autor: | Lyn M. Camire, Oluwatoyosi Ipaye, David S. Weisman, Amit D. Kalaria, Radhika Vij, Himanshu Rawal, Jeffrey S. Dubin |
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| Rok vydání: | 2020 |
| Předmět: |
Performance feedback
medicine.diagnostic_test Computed Tomography Angiography business.industry Angiography 030208 emergency & critical care medicine Computed tomography Emergency department medicine.disease Confidence interval Pulmonary embolism 03 medical and health sciences 0302 clinical medicine Emergency Medicine Pulmonary angiography Humans Medicine 030212 general & internal medicine Emergency Service Hospital Pulmonary Embolism business Nuclear medicine Retrospective Studies Volume (compression) |
| Zdroj: | The Journal of Emergency Medicine. 59:21-24 |
| ISSN: | 0736-4679 |
| DOI: | 10.1016/j.jemermed.2020.04.008 |
| Popis: | Background We examined utilization patterns and predictors of computed tomography pulmonary angiography (CTPA) results in the emergency department (ED). Objectives We retrospectively determined ED CTPA positive scan rate (PSR) among ED attendings based on a system that grouped attendings into scan quantity categories through >100. Methods We manually reviewed all scans ordered in 2017 in EDs in a multisite medical system. Results Of 10,032 ED CTPAs, 6168 were ordered by 153 ED attendings. Most attendings (123/153; 80%) ordered 60 or fewer scans with relatively high PSR (259/2927, PSR 8.8%; 95% confidence interval 7.8–9.9%). Of the ED attendings, 13 (3%) ordered more than 100 scans each (1981 scans; 32% of all scans), with PSR of 5.5% (95% confidence interval 4.5–6.5%). Conclusion Most ED attendings were low- to mid-volume utilizers of CTPA and had a relatively high PSR. However, the small percentage of attendings who ordered more than 100 scans each accounted for a large percentage of the total scan volume and had a relatively low PSR. These findings suggest that sharing of performance feedback and best practices in the highest utilizers could help to improve CTPA PSR in the ED. |
| Databáze: | OpenAIRE |
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