Rationale and Objectives: Quantify changes in total and by-subspecialty radiology workload due to deferring nonurgent services during the initial COVID-19 pandemic, and describe operational strategies implemented due to shifts in priority. Materials and Methods: This retrospective, Institutional Review Board-exempt, study was performed between February 3, 2020 and April 19, 2020 at a large academic medical center. During March 9À15 (intervention period), nonurgent outpatient service deferments began. Five-week periods pre-(baseline) and postintervention (COVID) were defined. Primary outcomes were radiology volume (reports per day) overall and in 11 subspecialty divisions. Linear regression assessed relationship between baseline vs. COVID volumes stratified by division. Secondary outcomes included changes in relative value units (RVUs), inpatient and outpatient volumes. Results: There were 62,791 baseline reports vs. 23,369 during COVID; a 60% overall precipitous volume decrease (p < 0.001). Mean volume decrease pre-and during-COVID was significant (p < 0.001) amongst all individual divisions. Mean volume decrease differed amongst divisions: Interventional Radiology experienced least disruption (29% volume decrease), 7 divisions experienced 40%À60% decreases, and Musculoskeletal, Breast, and Cardiovascular imaging experienced >75% volume decrease. Total RVUs decreased 60% (71,186 baseline; 28,476 COVID). Both outpatient and inpatient report volumes decreased; 72% (41,115 baseline; 11,326 COVID) and 43% (12,626 baseline vs. 6,845 COVID), respectively. In labor pool tracking data, 21.8% (162/744) total radiology employees were reassigned to other hospital duties during the intervention period. Conclusion: Precipitous radiology workload reductions impacted subspecialty divisions with marked variation. Data-driven operational decisions during COVID-19 assisted workflow and staffing assignment changes. Ongoing adjustments will be needed as healthcare systems transition operations to a "new normal."

The integration of biomolecules such as proteins, carbohydrates, or enzymes into functional materials, whether through physical or chemical coupling, remains a critical processing step in the fabrication of engineered biosensors or tissue scaffolds, where anisotropy and composition can directly impact material function and host integration. A means to achieve these features is through the selective patterning of biomolecules, which is used to recruit and direct cell growth in vitro. The authors describe the design of protein-based materials using inkjet printing and discuss how fluid physical properties of the formulated inks influence pattern formation and material performance. When interfaced with carbon nanotubes, the biohybrid films retain their chemical signature but with enhanced structural stability and electrical conductivity over time. These structures also support the adhesion and proliferation of human dermal fibroblasts. Together, these properties demonstrate the utility of printed biohybrid films as materials that can conceivably be used to recapitulate or enhance biological function for tissue engineering applications.

ObjectivesThe aims of the study were to assess a system-based approach to event investigation and analysis—collaborative case reviews (CCRs)—and to measure impact of clinical specialty on strength of action items prescribed.MethodsA fully integrated CCR process, co-led by radiology and an institutional patient safety program, was implemented on November 1, 2017, at our large academic medical center for evaluating adverse events involving radiology. Quality and safety teams performed reviews for events identified with other departments who maintained their existing processes. This institutional review board–approved study describes the program, including percentage of CCR from an institutional Electronic Safety Reporting System, percentage of CCR per specialty, and action item completion rates and strength (e.g., stronger) based on a Veterans Administration–designed hierarchy. χ2 analysis assessed impact of clinical specialty on strength of action prescribed.ResultsSeventy-three CCR in 2018 generated 260 action items from 10 specialties. Seventy percent (51/73) were adverse events identified through Electronic Safety Reporting System. The specialty most frequently associated with CCR was radiology (16/73, 22%). Most action items (204/260, 78%) were completed in 1 year; stronger action items were completed in 71 (27%) of 260. Radiology was responsible for 61 action items; 25 (41%) of 61 were strong versus all other specialties with strong action items in 46 (23%) of 199 (P < 0.01).ConclusionsAn integrated multispecialty CCR co-led by the radiology department and an institutional patient safety program was associated with a higher proportion of CCR, stronger action items, and higher action item completion rate versus other hospital departments. Active engagement in CCR can provide insights into addressing adverse events and promote patient safety.

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