Improving timeliness of STAT portable radiographs in pediatric critical care.

IF 2.3 3区医学 Q2 PEDIATRICS Pediatric Radiology Pub Date : 2025-05-01 Epub Date: 2025-03-29 DOI:10.1007/s00247-025-06224-3

Marcy L Hutchinson, Mohammad Jalloul, Brandon Stormes, Addison A McInnes, Hannah Stinson, Kumar Ashwarya, Valerie A Rigby, Summer L Kaplan

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Abstract

Background: Timely and accurate portable radiographs are essential in the pediatric intensive care unit (PICU) for managing critically ill patients. However, an overuse of STAT orders for non-urgent exams leads to inefficiencies, delays, and strains on resources. This project aimed to increase the percentage of STAT radiographs performed within 30 min and improve the appropriateness of STAT orders in a high-volume PICU.

Methods: A quality improvement initiative was conducted in a quaternary care pediatric hospitals using the ACR ImPower methodology. A multidisciplinary team restructured the technologist staffing model, introduced standardized criteria for STAT/ASAP orders, and developed a communication tip sheet for nursing staff ordering portable radiographs. Data were tracked using statistical process control charts, and results were compared pre- and post-intervention.

Results: From January to September 2024, STAT radiographs completed within 30 min increased from 55 to 71%, and mean turnaround time decreased from 71 to 38 min. Compliance with communication standards improved, while the appropriateness of STAT orders increased modestly from 42 to 44%.

Conclusion: This QI project significantly improved the timeliness and workflow efficiency for STAT radiographs in the PICU, though further efforts are needed to fully standardize STAT order usage and communication practices.

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提高STAT便携式x线片在儿科重症监护中的及时性。

背景：及时、准确的便携式x线片在儿科重症监护病房（PICU）管理危重患者中至关重要。然而，对非紧急考试过度使用STAT命令会导致效率低下、延迟和资源紧张。该项目旨在提高30分钟内完成STAT x线片的比例，并提高STAT指令在大容量PICU中的适用性。方法：采用ACR ImPower方法在一家四级护理儿科医院开展质量改进活动。一个多学科团队重组了技术人员配置模式，引入了STAT/ASAP订单的标准化标准，并为护理人员订购便携式x光片制定了沟通提示表。采用统计过程控制图对数据进行跟踪，并对干预前后的结果进行比较。结果：从2024年1月到9月，30分钟内完成的STAT x线片从55%增加到71%，平均周转时间从71分钟减少到38分钟。通信标准的依从性提高，而STAT指令的适当性从42%适度增加到44%。结论：该QI项目显著提高了PICU STAT x线片的及时性和工作流程效率，但需要进一步努力来完全规范STAT指令的使用和沟通实践。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.