Abstract：
Follow established management guidelines from the ACR and improve adherence to follow-up recommendations for incidental liver lesions (ILLs) for all patients undergoing CT abdomen and pelvis with contrast (CTAPw) examinations, with advocacy from a multidisciplinary care team.
A mandatory structured radiology reporting module was developed for use in CTAPw reports for ILL recommendations. Data from the electronic medical record describing patients with radiology-reported ILLs and their clinical risk diagnosis categories were tabulated in a queryable electronic database. A nurse co-ordinator initiated workflow to communicate the need for ILL follow-up MRI to ordering physicians and primary care providers. MRIs were ordered by the ILL team. An interactive process was undertaken with continuous review to improve identification of eligible patients and adherence to recommendations.
During the initial launch phase from December 2020 to March 2021, 1,577 ILLs were detected on 20,667 CTAPw examinations, and for those with the characterize now recommendation, 36 of 114 (31.6%) received follow-up in 30 days. Between January 2021 and June 2022, 117,520 CTAPws were performed and 4,371 ILLs were detected. Using the ILL workflow, in the MRI now cohort, follow-up occurred within 30 days in 202 of 542 (36.2%) patients, and a total of 368 of 542 (67.9%) patients have completed their follow-up to date.
Using a focused effort to close a gap in ILL care, adherence to follow-up recommendations improved over the long term, although there remains a gap in adherence to short-term interventions. A multidisciplinary approach, radiology reporting, and software solutions were leveraged to improve a complex process.
A mandatory structured radiology reporting module was developed for use in CTAPw reports for ILL recommendations. Data from the electronic medical record describing patients with radiology-reported ILLs and their clinical risk diagnosis categories were tabulated in a queryable electronic database. A nurse co-ordinator initiated workflow to communicate the need for ILL follow-up MRI to ordering physicians and primary care providers. MRIs were ordered by the ILL team. An interactive process was undertaken with continuous review to improve identification of eligible patients and adherence to recommendations.
During the initial launch phase from December 2020 to March 2021, 1,577 ILLs were detected on 20,667 CTAPw examinations, and for those with the characterize now recommendation, 36 of 114 (31.6%) received follow-up in 30 days. Between January 2021 and June 2022, 117,520 CTAPws were performed and 4,371 ILLs were detected. Using the ILL workflow, in the MRI now cohort, follow-up occurred within 30 days in 202 of 542 (36.2%) patients, and a total of 368 of 542 (67.9%) patients have completed their follow-up to date.
Using a focused effort to close a gap in ILL care, adherence to follow-up recommendations improved over the long term, although there remains a gap in adherence to short-term interventions. A multidisciplinary approach, radiology reporting, and software solutions were leveraged to improve a complex process.
摘要：
目的：遵循ACR的既定管理指南，并提高对所有接受CT腹部和骨盆造影（CTAPw）检查的患者的偶发性肝脏病变（ILLs）的随访建议的依从性。在多学科护理团队的倡导下。
方法：开发了一种强制性结构化放射学报告模块，用于CTAPw报告中的ILL建议。来自电子病历的数据描述了放射学报告的ILL患者及其临床风险诊断类别，并在可查询的电子数据库中列出。护士协调员启动了工作流程，将对ILL随访MRI的需求传达给订购医生和初级保健提供者。MRI是由ILL团队订购的。通过持续审查进行互动过程，以提高对合格患者的识别和对建议的依从性。
结果：在2020年12月至2021年3月的初始发射阶段，在20,667个CTAPw检查中检测到1,577个ILL，对于那些现在推荐的人来说，114人中有36人（31.6％）在30天内接受了随访。在2021年1月至2022年6月之间，进行了117,520次CTAPws，并检测到4,371次ILL。使用ILL工作流程，在MRI现在队列中，542例患者中有202例（36.2%）在30天内进行了随访，迄今为止，542名患者中有368名（67.9％）完成了随访。
结论：通过集中努力缩小在疾病护理方面的差距，从长远来看，对后续建议的遵守情况有所改善，尽管短期干预措施的依从性仍存在差距.多学科方法，放射学报告，和软件解决方案被用来改进一个复杂的过程。
方法：开发了一种强制性结构化放射学报告模块，用于CTAPw报告中的ILL建议。来自电子病历的数据描述了放射学报告的ILL患者及其临床风险诊断类别，并在可查询的电子数据库中列出。护士协调员启动了工作流程，将对ILL随访MRI的需求传达给订购医生和初级保健提供者。MRI是由ILL团队订购的。通过持续审查进行互动过程，以提高对合格患者的识别和对建议的依从性。
结果：在2020年12月至2021年3月的初始发射阶段，在20,667个CTAPw检查中检测到1,577个ILL，对于那些现在推荐的人来说，114人中有36人（31.6％）在30天内接受了随访。在2021年1月至2022年6月之间，进行了117,520次CTAPws，并检测到4,371次ILL。使用ILL工作流程，在MRI现在队列中，542例患者中有202例（36.2%）在30天内进行了随访，迄今为止，542名患者中有368名（67.9％）完成了随访。
结论：通过集中努力缩小在疾病护理方面的差距，从长远来看，对后续建议的遵守情况有所改善，尽管短期干预措施的依从性仍存在差距.多学科方法，放射学报告，和软件解决方案被用来改进一个复杂的过程。
