Protecting trauma patients from duplicated computed tomography scans: the relevance of integrated care systems - 22/09/14
, Joseph Bledsoe, M.D. b, Mark H. Stevens, M.D. c, Amalia Cochran, M.D. dAbstract |
Background |
Duplicated computed tomography (CT) scans in transferred trauma patients have been described in university-based trauma systems. This study compares CT utilization between a university-based nonintegrated system (NIS) and a vertically integrated regional healthcare system (IS).
Methods |
Trauma patients transferred to 2 Level I trauma centers were prospectively identified at the time of transfer. Imaging obtained before and subsequent to transfer and the reason for CT imaging at the Level I center were captured by real-time reporting.
Results |
Four hundred eighty-one patients were reviewed (207 at NIS and 274 at IS). Ninety-nine patients (48%) at NIS and 45 (16%) at IS underwent duplicate scanning of at least one body region. Inadequate scan quality and incomplete imaging were the most common reason category reported at NIS (54%) and IS (78%).
Conclusions |
Fewer patients received duplicated scans within the vertically IS as compared with a traditional university-based referral system. Our findings suggest that the adoption of features of a vertically IS, particularly improved transferability of radiographic studies, may improve patient care in other system types.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Two tertiary trauma centers are examined, one within a integrated healthcare system and the other within a non-integrated healthcare system. |
• | We observed the difference in duplication of CT scan acquisition in transferred trauma patients between the two centers. |
• | The integrated system has fewer patients that received duplicated CT scans than the non-integrated system. |
• | The reasons, as given by the receiving trauma surgeon, for these differences were collected in a prospective manner. |
Keywords : Trauma care, Interfacility transfer, Duplicated CT scans
Plan
| Amy E. Liepert had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. |
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| There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs. |
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| The authors declare no conflicts of interest. |
Vol 208 - N° 4
P. 511-516 - octobre 2014 Retour au numéro
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