Early Experience Using an Online Reporting System for Interventional Radiology Procedure-Related Complications Integrated with a Digital Dictation System |
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Authors: | Sanjay Gupta Jay Patel Kevin McEnery Michael J Wallace Kamran Ahrar Chuck Suitor and Marshall E Hicks |
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Institution: | (1) From Department of Diagnostic Radiology, University of Texas M D Anderson Cancer Center, Houston, 77030, Texas;(2) EMR Development and Support, University of Texas M D Anderson Cancer Center, Houston, 77030, Texas;(3) Department of Diagnostic Radiology, The University of Texas M D Anderson Cancer Center, Unit 325, 1515 Holcombe Blvd., Houston, TX, 77030, Texas |
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Abstract: | The absence of user-friendly systems for reporting complications is a major barrier to improving quality assurance (QA) programs
in interventional radiology (IR) services. We describe the implementation of a QA application that is completely integrated
with the radiology dictation system. We implemented an IR QA process as a module within the electronic medical record and
radiologist dictation system applications used at our institution. After a radiologist completes a dictation, he or she must
select from a drop-down list of complications before proceeding to the next case. Delayed QA events can be entered using the
same applications. All complication entries are sent to a database, which is queried to run reports. During the study period,
all the 20,034 interventional procedures were entered in the QA database, 1,144 complications were reported, 110 (9.6%) of
which were classified as major. Although majority of the complications (996) were entered at the time of dictation, 148 complications
(12.9%) were entered afterwards. All major complications were referred to the IR peer review committee, and 30 of these were
discussed in the morbidity and mortality meetings. We studied post-lung-biopsy pneumothorax and chest tube rates and initiated
a quality improvement process based on the results.The integration of the IR QA reporting system into the workflow process
and the mandatory requirements for completion has the potential to minimize the work effort required to enter complication
data, and improve participation in the QA process. |
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