Changing primary care requesting practices for MRI knee: A quality improvement project.

The objectives of this work were first to examine referral practices from primary care for MRI knee in patients ≥45 years old and then to develop a new referral pathway to reduce the number of inappropriate MRI knee referrals. Following this, the aim was to re-assess the effect of the intervention a...

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Publicado en:Radiography Vol. 29; no. 3; pp. 519 - 526
Autores principales: Robinson, E., Rajayogeswaran, B., Walton, E.
Formato: research Journal Article
Publicado: W B Saunders May2023
Acceso en línea:Ver este registro en EBSCOhost
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      pub: W B Saunders
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        10.1016/j.radi.2023.02.026
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        atl: Changing primary care requesting practices for MRI knee: A quality improvement project.
      aug:
        au:
          Robinson, E.
          Rajayogeswaran, B.
          Walton, E.
        affil: FRCR, North Bristol NHS Trust, UK
      sug:
        subj:
          Quality Improvement
          Primary Health Care
          Referral and Consultation Evaluation
          Critical Path
          Unnecessary Procedures
          Magnetic Resonance Imaging
          Knee Joint Radiography
          Human
          Middle Age
          Retrospective Design
          Descriptive Statistics
          Implementation Science
          Guideline Adherence
          Middle Aged: 45-64 years
      ab: The objectives of this work were first to examine referral practices from primary care for MRI knee in patients ≥45 years old and then to develop a new referral pathway to reduce the number of inappropriate MRI knee referrals. Following this, the aim was to re-assess the effect of the intervention and identify further areas for improvement. A baseline retrospective analysis of knee MRIs requested from primary care in symptomatic patients ≥45years over a two-month period was undertaken. A new referral pathway was implemented in consensus with orthopaedic specialists and the clinical commissioning group (CCG), via the CCG resource webpage and local education. Following implementation, a repeat data analysis was undertaken. The number of MRI knees acquired from primary care referrals reduced by 42% after the new pathway was implemented. 67% (46/69) were compliant with the new guidelines. The number of patients having an MRI knee without a prior plain radiograph was 14/69 (20%) compared to 55/118 (47%) prior the pathway changes. The new referral pathway reduced the number of knee MRI acquisitions in primary care patients ≥45 years by 42%. Changing the pathway has decreased the number of patients undergoing MRI knee without a prior radiograph from 47% to 20%. These outcomes bring our standards towards the evidence-based recommendations of the Royal College of Radiology and have reduced our outpatient waiting list for MRI knee. Implications for practice: Implementing a new referral pathway with the local CCG can successfully reduce the number of inappropriate MRI knee acquisitions from primary care referrals in older symptomatic patients.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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