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Outpatient imaging efficiency

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https://www.readbyqxmd.com/read/27795820/cost-of-illness-among-patients-with-diabetic-foot-ulcer-in-turkey
#1
Ergun Oksuz, Simten Malhan, Bilge Sonmez, Rukiye Numanoglu Tekin
AIM: To evaluate the annual cost of patients with Wagner grade 3-4-5 diabetic foot ulcer (DFU) from the public payer's perspective in Turkey. METHODS: This study was conducted focused on a time frame of one year from the public payer's perspective. Cost-of-illness (COI) methodology, which was developed by the World Health Organization, was used in the generation of cost data. By following a clinical path with the COI method, the main total expenses were reached by multiplying the number of uses of each expense item, the percentage of cases that used them and unit costs...
October 15, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/27782870/factors-associated-with-the-decision-of-the-rheumatologist-to-order-sacroiliac-joints-magnetic-resonance-imaging-si-mri-or-hla-b27-testing-in-the-diagnostic-work-up-of-patients-with-spondyloarthritis-in-clinical-practice
#2
Wilson Bautista-Molano, Robert B M Landewé, Cesar Serna, Rafael Valle-Oñate, Désirée van der Heijde
OBJECTIVES: To evaluate the patients' characteristics associated with the clinical decision to request SI-MRI and/or HLA-B27 in patients with SpA in daily practice. METHODS: Patients referred to a rheumatology outpatient-clinic in a national referral-centre were selected. Patients with a clinical diagnosis of SpA according to the rheumatologist were included. SI-MRI and HLA-B27 was available for patients in whom the rheumatologists had ordered these tests. Characteristics associated with ordering SI-MRI or HLA-B27 were identified with univariable analyses...
October 26, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27686648/telehealth-interventions-for-reducing-waiting-lists-and-waiting-times-for-specialist-outpatient-services-a-scoping-review
#3
Liam J Caffery, Mutaz Farjian, Anthony C Smith
We undertook a scoping review of the published literature to identify and summarise key findings on the telehealth interventions that influence waiting times or waiting lists for specialist outpatient services. Searches were conducted to identify relevant articles. Articles were included if the telehealth intervention restructured or made the referral process more efficient. We excluded studies that simply increased capacity. Two categories of interventions were identified - electronic consultations and image-based triage...
September 28, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27557630/strategies-for-assessing-renal-function-prior-to-outpatient-contrast-enhanced-ct-a-uk-survey
#4
Martine Ann Harris, Beverly Snaith, Ruth Clarke
OBJECTIVES: To identify current UK screening practices prior to contrast-enhanced computerised tomography (CT). To determine the patient management strategies to minimise the risk of contrast induced acute kidney injury risk (CI-AKI) in outpatients. METHODS: An invitation to complete an electronic survey was distributed to the CT managers of 174 UK adult NHS hospital trusts. The survey included questions related to local protocols and national guidance on which these are based...
August 25, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27504650/the-mini-c-arm-adds-quality-and-efficiency-to-the-pediatric-orthopedic-outpatient-clinic
#5
Matthew G Fanelli, William L Hennrikus, Jennifer M Slough Hill, Douglas G Armstrong, Steven H King
The mini C-arm has become increasingly popular in the practice of orthopedics. To the authors' knowledge, its use in the pediatric orthopedic outpatient clinic has not been reported. The purpose of this study was to evaluate the practice efficiency and radiation exposure to the patient when the mini C-arm was used in the pediatric orthopedic outpatient clinic. One hundred consecutive midshaft and distal forearm fractures were evaluated by one orthopedic surgeon in follow-up using a mini C-arm. For each case, the radiation physicist calculated the amount of skin exposure in milligray (mGy)...
November 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27493745/improving-the-safety-and-efficiency-of-outpatient-lumbar-puncture-service
#6
Mark Sweeney, Adam Al-Diwani, Robert Hadden
Lumbar puncture (LP) is a commonly performed procedure in diagnosis and management of neurological conditions. LP is generally safe, however there are a number of potentially serious complications, including epidural haematoma and cerebral herniation. The risks of these should be considered and minimised prior to undertaking LP. Our regional neuroscience centre provides an outpatient LP service for patients throughout southeast England. Referrals from distant hospitals meant there was frequently no access to important clinical information, including indication for LP, past medical history, or medication history until the day of the procedure, and no access to results of investigations such as coagulation profile, platelet count, or intracranial imaging...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27318582/impact-of-the-new-jersey-breast-density-law-on-imaging-and-intervention-volumes-and-breast-cancer-diagnosis
#7
Linda M Sanders, Alexander B King, Koren S Goodman
PURPOSE: Increased breast density is acknowledged as an independent risk factor for breast cancer and may obscure malignancy on mammography. Approximately half of all mammograms depict dense breasts. Legislation related to mandatory breast density notification was first enacted in Connecticut in 2009. On May 1, 2014, New Jersey joined other states with similar legislation. The New Jersey breast density law (NJBDL) mandates that mammography reports acknowledge the relevance and masking effect of mammographic breast density...
June 16, 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27318577/the-patient-experience-in-radiology-observations-from-over-3-500-patient-feedback-reports-in-a-single-institution
#8
Andrew B Rosenkrantz, Kristine Pysarenko
PURPOSE: To identify factors associated with the patient experience in radiology based on patient feedback reports from a single institution. METHODS: In a departmental patient experience committee initiative, all imaging outpatients are provided names and roles of all departmental employees with whom they interact, along with contact information for providing feedback after their appointment. All resulting feedback was recorded in a web-based database. A total of 3,675 patient comments over a 3-year period were assessed in terms of major themes...
June 16, 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27295173/core-needle-biopsy-in-the-diagnosis-of-head-and-neck-lesions-a-retrospective-study-of-3%C3%A2-years
#9
Vitor Hugo Candido Ferreira, Laurindo Moacir Sassi, Roberta Targa Stramandinoli Zanicotti, Gyl Henrique Albrecht Ramos, Juliana Elizabeth Jung, Juliana Lucena Schussel
The management of head and neck tumors is guided by its nature, location and extension. Despite CNB accuracy and efficiency being widely described in the literature, there are few studies that evaluate the diagnostic utility of the technique performed in an outpatient setting, in the diagnosis of head and neck tumors. The aim of this study is to present the experience, sensitivity, specificity and accuracy of the CNB performed in an outpatient setting, free handed, in an important oncology school-hospital. A total of 2007 patients with tumors in the head and neck treated for a period of 3 years were evaluated...
June 13, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27160008/fulfilling-outpatient-medicine-responsibilities-during-internal-medicine-residency-a-quantitative-study-of-housestaff-participation-with-between-visit-tasks
#10
Jason Hom, Ilana Richman, Jonathan H Chen, Baldeep Singh, Casey Crump, Jeffrey Chi
BACKGROUND: Internal Medicine residents experience conflict between inpatient and outpatient medicine responsibilities. Outpatient "between visit" responsibilities such as reviewing lab and imaging data, responding to medication refill requests and replying to patient inquiries compete for time and attention with inpatient duties. By examining Electronic Health Record (EHR) audits, our study quantitatively describes this balance between competing responsibilities, focusing on housestaff participation with "between visit" outpatient responsibilities...
2016: BMC Medical Education
https://www.readbyqxmd.com/read/27118098/determining-waiting-room-occupancy-at-an-outpatient-clinic-using-simulated-observations-and%C3%A2-probability-duration-curves
#11
Jing Ai, Catherine Oglevee, Oleg Pianykh
Adequate allocation of physical resources in hospitals has become increasingly important with the rise of health care costs. Seat utilization in outpatient clinic waiting rooms is one resource that is particularly important to monitor, to not only ensure patient satisfaction but also accommodate patient flow. Currently, very few studies are available on seat occupancy and patient flow in standard waiting rooms, and studies often neglect important factors, such as hourly patterns of patient influx and occupancy duration...
June 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/26977554/current-evidence-of-minimally-invasive-spine-surgery-in-the-treatment-of-lumbar-disc-herniations
#12
REVIEW
Martin Quirno, Shaleen Vira, Thomas J Errico
With the advent of new instrumentation and better imaging techniques that allowed less tissue trauma compared with traditional open procedures, while providing adequate or enhanced visualization of the pathologic site and based upon the successful experience of outpatient spine surgery to assist early ambulation, the trend and evolution toward ''minimal access'' or minimally invasive spine surgery began to develop with greater intensity. Many surgical techniques have flourished with the promise of delivering a safe and efficient alternative, including chemonucleolysis, manual percutaneous discectomy (MPD), automated percutaneous lumbar discectomy (APLD), and percutaneous lumbar laser discectomy (PLLD)...
March 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/26945021/improving-diagnostic-accuracy-and-efficiency-of-suspected-bone-stress-injuries-algorithm-and-clinical-prediction-rule
#13
Nathaniel S Nye, Carlton J Covey, Lucas Sheldon, Bryant Webber, Mary Pawlak, Barry Boden, Anthony Beutler
CONTEXT: Lower extremity stress fractures among athletes and military recruits cause significant morbidity, fiscal costs, and time lost from sport or training. During fiscal years (FY) 2012 to 2014, 1218 US Air Force trainees at Joint Base San Antonio-Lackland, Texas, were diagnosed with stress fracture(s). Diagnosis relied heavily on bone scans, often very early in clinical course and often in preference to magnetic resonance imaging (MRI), highlighting the need for an evidence-based algorithm for stress injury diagnosis and initial management...
March 4, 2016: Sports Health
https://www.readbyqxmd.com/read/26908402/practice-level-variation-in-outpatient-cardiac-care-and-association-with-outcomes
#14
Jeffrey D Clough, Rahul Rajkumar, Matthew T Crim, Lesli S Ott, Nihar R Desai, Patrick H Conway, Sha Maresh, Daver C Kahvecioglu, Harlan M Krumholz
BACKGROUND: Utilization of cardiac services varies across regions and hospitals, yet little is known regarding variation in the intensity of outpatient cardiac care across cardiology physician practices or the association with clinical endpoints, an area of potential importance to promote efficient care. METHODS AND RESULTS: We included 7 160 732 Medicare beneficiaries who received services from 5635 cardiology practices in 2012. Beneficiaries were assigned to practices providing the plurality of office visits, and practices were ranked and assigned to quartiles using the ratio of observed to predicted annual payments per beneficiary for common cardiac services (outpatient intensity index)...
February 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/26869656/recap-detection-of-potentially-avoidable-harm-in-oncology-from-patient-medical-records
#15
Allison Lipitz-Snyderman, Saul N Weingart, Christopher Anderson, Andrew S Epstein, Aileen Killen, David Classen, Camelia S Sima, Elizabeth Fortier, Coral L Atoria, David Pfister, Allison Lipitz-Snyderman, Saul N Weingart, Christopher Anderson, Andrew S Epstein, Aileen Killen, David Classen, Camelia S Sima, Elizabeth Fortier, Coral L Atoria, David Pfister
PURPOSE: Widespread consensus exists about the importance of addressing patient safety issues in oncology, yet our understanding of the frequency, spectrum, and preventability of adverse events (AEs) across cancer care is limited. METHODS: We developed a screening tool to detect AEs across cancer care settings through medical record review. Members of the study team reviewed the scientific literature and obtained structured input from an external multidisciplinary panel of clinicians by using a modified Delphi process...
February 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/26843275/highly-sensitive-troponin-and-coronary-computed-tomography-angiography-in-the-evaluation-of-suspected-acute-coronary-syndrome-in-the-emergency-department
#16
REVIEW
Maros Ferencik, Udo Hoffmann, Fabian Bamberg, James L Januzzi
The evaluation of patients presenting to the emergency department with suspected acute coronary syndrome (ACS) remains a clinical challenge. The traditional assessment includes clinical risk assessment based on cardiovascular risk factors with serial electrocardiograms and cardiac troponin measurements, often followed by advanced cardiac testing as inpatient or outpatient (i.e. stress testing, imaging). Despite this costly and lengthy work-up, there is a non-negligible rate of missed ACS with an increased risk of death...
August 7, 2016: European Heart Journal
https://www.readbyqxmd.com/read/26822731/same-day-sinus-and-brain-ct-imaging-in-the-medicare-population-are-practice-patterns-changing-in-association-with-medicare-policy-initiatives
#17
H Kroll, R Duszak, J Hemingway, D Hughes, M Wintermark
BACKGROUND AND PURPOSE: Monitoring the frequency of same-day sinus and brain CT (Outpatient Measure 14, "OP-14") is part of a recent large Centers for Medicare and Medicaid Services hospital outpatient quality initiative to improve imaging efficiency. This study investigates patient-level claims data in the Medicare population focusing on where same-day sinus and brain CT imaging is performed and how the frequency of same-day studies changed with time before and during OP-14 measure program implementation...
June 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/26707364/rapid-quantitative-d-dimer-to-exclude-pulmonary-embolism-a-prospective-cohort-management-study
#18
S M Bates, S Takach Lapner, J D Douketis, C Kearon, J Julian, S Parpia, S Schulman, J I Weitz, L A Linkins, M Crowther, W Lim, F A Spencer, A Y Y Lee, P L Gross, J Ginsberg
UNLABELLED: ESSENTIALS: It is not known if D-dimer testing alone can safely exclude pulmonary embolism (PE). We studied the safety of using a quantitative latex agglutination D-dimer to exclude PE in 808 patients. 52% of patients with suspected PE had a negative D-dimer test and were followed for 3 months. The negative predictive value of D-dimer testing alone was 99.8%, suggesting it may safely exclude PE. SUMMARY: HASH(0x3a436f8) BACKGROUND: Strategies are needed to exclude pulmonary embolism (PE) efficiently without the need for imaging tests...
March 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/26700263/cone-beam-ct-paranasal-sinuses-versus-standard-multidetector-and-low-dose-multidetector-ct-studies
#19
COMPARATIVE STUDY
Janan Al Abduwani, Laura ZilinSkiene, Steve Colley, Shahzada Ahmed
UNLABELLED: Cone-beam computed tomography (CBCT) is a promising modality for quick outpatient imaging with lower radiation dose and less metal artifact when compared to conventional CT (MDCT) scans. This article will be providing evidence on the diagnostic and treatment-planning applications of CBCT in sinus imaging, mainly, in patients with chronic sinusitis for surgical planning, which retrospectively assessed 21 patients over a period of one year at Queen Elisabeth Hospital, Birmingham, UK...
January 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/26370585/successful-melanoma-triage-by-a-virtual-lesion-clinic-teledermatoscopy
#20
A T Congalton, A M Oakley, M Rademaker, D Bramley, R C W Martin
BACKGROUND: A Virtual Lesion Clinic (VLC) using teledermatoscopy was established to improve efficiency of the melanoma referral pathway. OBJECTIVES: To assess diagnostic accuracy and to compare wait-times and costs of VLC and conventional clinics. METHODS: Patients with suspected melanoma referred from primary care into a publicly funded health system attended local skin imaging centres, rather than hospital outpatient clinics. A teledermatologist assessed each lesion choosing specialist assessment/excision, General Practitioner (GP) follow-up, to re-image in 3 months, or self-monitoring/no concern...
December 2015: Journal of the European Academy of Dermatology and Venereology: JEADV
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