I am sure there are other items you could identify to include in your mid-year "check-up." Regardless of facility type, range of offered services, and/or size of the facility I am confident you can find some opportunity to make things better if you will only look. Check-ups aren't a bad thing--as medical professionals, you should welcome the opportunity!
The primary purpose of obtaining laser targeting devices for C-arm fluoroscopy was to attempt to reduce radiation to the pediatric population in Connecticut Children's Medical Center's commitment to Imaging Gently. Fluoroscopy times for placing central lines in the operating rooms were documented for two months prior to the installation of the lasers and then for twenty procedures after installation and training on the devices. Fluoroscopy times trended down 25% calculated by a simple mean and standard deviation.
The cultural acceptance of workplace violence is changing. Management has become more educated on regulatory issues around its tolerance of workplace violence. Events around the country in a variety of settings have aided in raising awareness of this issue. Healthcare professionals are not immune to workplace violence, including those working in the imaging profession. Healthcare workers, historically, have given care despite the demeanor of patients, often putting up with aggressive behavior including sexual harassment and physical assault. Management needs to take all possible measures to ensure employees feel safe at work. It is essential to have well thought out policies and procedures to mitigate workplace violence; keeping in mind that a goal of eliminating workplace violence is unrealistic.
A grant from the AHRA and Toshiba Putting Patients First program enabled Fairview Health System in Minneapolis, MN to launch an interactive education website which provides best practice information for CT usage in head trauma and appendicitis cases. The website, PEMguidelines.org contains educational sections geared toward both clinicians and patients and families. The site provides evidenced based guidelines for the management of head trauma and appendicitis. PEMguidelines.org was rolled out in 2012 as part of a three pronged intervention strategy. A linkto the website was included in new clinical order-sets within the Fairview electronic health system. Clinical decision support aids were also embedded in the medical record system. Fairview held provider education sessions for ED physicians and staff to introduce and promote the new approach. Results from a six month period after the initial roll out indicate a decrease of 15% in abdominal CT scans for suspected appendicitis cases, while the numbers of missed cases did not increase.This initial evidence supports the effectiveness of this multilevel strategy in improving the safety and cost-effectiveness of pediatric CT use in diagnosis of appendicitis.
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