Point-of-Care Reference Materials Increase Practice Compliance With Societal Guidelines for Incidental Findings in Emergency Imaging

National Survey of Hospitalists' Experiences with Incidental Pulmonary Nodules

“…Compliance with use of the template by radiologists is followed monthly. After a run-in period, almost 100% of chest CT reports use the structured template, consistent with published findings from similar initiatives, 14 and 100% of patients with new IPNs identified on the inpatient Medicine services have had an IPN consult.…”

Management Strategies to Promote Follow-Up Care for Incidental Findings: A Scoping Review

“…Electronic Guideline References. Four studies used electronic guideline references embedded within electronic radiology reporting and communication systems to provide radiologists easy access to guidelines and follow-up recommendations (phase 2) [20][21][22][23]. One study also used electronic guideline references to influence clinician behavior (phase 3) when reading radiologists' recommendations [23].…”

“…The program was designed for radiologists to reference when formulating follow-up recommendations [20]. Zygmont et al created an electronic document summarizing all societal guidelines for IF management that could be accessed via voice recognition software [21]. Eldeiry et al studied radiologists' use of a clinical algorithm that imbedded guideline-based imaging and laboratory study recommendations in the "impressions" section of the radiology report [22].…”

“…The most commonly reported metric to evaluate management strategy success was the rate of patients receiving recommended follow-up care (n ¼ 6; Table 1) measured by reviewing percent of patient with documented follow-up care [18,27], guideline-concordant care [20,24,28], and surveillance imaging [22]. Five studies measured the proportion of patients with follow-up care recommendations documented in their clinical record [17,20,21,23,25], whether or not that care was delivered. Two studies measured time [26] or costs [31] associated with IF management.…”

“…Phases 3, 2, and 6 had the most described metrics with nine, eight, eight, respectively. Six studies measured percent of guideline-concordant versus Percent of radiology reports drafted by a trainee 1 [21] Average time for clinical staff to document IF follow-up recommendations in patient chart 1 [30] Percent of reports with missing or incomplete radiologist recommendations for follow-up 2 [21,24] Percent of reports with radiologist recommending imaging surveillance 3 [23,24,26] Percent of reports with radiologist recommending surgical or specialist consultation 1 [24] Percent of radiologist recommended followup care that is guideline-concordant vs guideline-discordant 5 [21,24,25,27,28] Percent of guideline discordant radiologist recommendations that would result in over-or undermanagement 1 [21] Phase 3: Ordering clinician receives image study results, follow-up care recommendations (n ¼ 9). Percent of patients with documentation of the IF in their patient chart 1 [22] Percent of patients with any type of followup care recommendation in their patient chart 1 [30] Percent of patient records with documented communication between the radiologist and ordering clinician about the IF 2 [23,34] Percent of clinician recommended follow-up that is guideline-concordant vs guidelinediscordant 1 [29] Percent of clinician types ordering follow-up imaging studies (eg, PCPs, pulmonologists, emergency medicine)…”