High Scan Volume with Low Positive Scan Rate in Highest Utilizers: Computed Tomography Pulmonary Angiography in the Emergency Department.
Citation: Journal of Emergency Medicine. 2020 May 04PMID: 32381340Institution: MedStar Good Samaritan Hospital | Medstar Union Memorial Hospital | MedStar Washington Hospital CenterDepartment: Medical Director | RadiologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2020Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:- 0736-4679
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 32381340 | Available | 32381340 |
Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
BACKGROUND: We examined utilization patterns and predictors of computed tomography pulmonary angiography (CTPA) results in the emergency department (ED).
CONCLUSION: Most ED attendings were low- to mid-volume utilizers of CTPA and had a relatively high PSR. However, the small percentage of attendings who ordered more than 100 scans each accounted for a large percentage of the total scan volume and had a relatively low PSR. These findings suggest that sharing of performance feedback and best practices in the highest utilizers could help to improve CTPA PSR in the ED. Copyright (c) 2020 Elsevier Inc. All rights reserved.
METHODS: We manually reviewed all scans ordered in 2017 in EDs in a multisite medical system.
OBJECTIVES: We retrospectively determined ED CTPA positive scan rate (PSR) among ED attendings based on a system that grouped attendings into scan quantity categories through >100.
RESULTS: Of 10,032 ED CTPAs, 6168 were ordered by 153 ED attendings. Most attendings (123/153; 80%) ordered 60 or fewer scans with relatively high PSR (259/2927, PSR 8.8%; 95% confidence interval 7.8-9.9%). Of the ED attendings, 13 (3%) ordered more than 100 scans each (1981 scans; 32% of all scans), with PSR of 5.5% (95% confidence interval 4.5-6.5%).
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