Point-of-care reference material increases ED compliance with societal guidelines

In theory, compliance with societal guidelines should result in improved patient care and cost savings. But what if compliance is low? According to a new study published by the Journal of the American College of Radiology, one way to increase guideline compliance is providing specialists with point-of-care decision support reference materials.

Matthew E. Zygmont, MD, Emory University Midtown Hospital in Atlanta, and colleagues analyzed imaging events that occurred in two emergency departments from Sept. 1, 2014, to Nov. 1, 2014, tracking the management of incidental findings (IF). The team then created a 16-page document summarizing various societal guidelines and educated the facility’s emergency radiology division about the use of those guidelines.

“In this short (less than one hour) meeting, we did not try to teach the guidelines to the radiologists but rather educated radiologists about the importance of following guidelines and informed them about the three easy ways they could access these guidelines: (1) precreated PowerScribe 360 macros for all guidelines, (2) the short 16-page book at every workstation, and (3) an electronic version of the guideline book with electronic links in the table of contents,” the authors wrote.

To see if that education made an impact, Zygmont et al. once again analyzed imaging events for two months, and they did it exactly one year later.

How did the team do? According to the authors’ data, there was significant improvement.

During the two-month period before the intervention, more than 3,100 total cases resulted in 514 IFs. Concordance with societal guidelines was more than 67 percent of all IFs.

During the two-month period after the intervention, more than 3,700 total cases resulted in 499 IFs. Concordance with society guidelines was more than 80 percent of all IFs.

“The practice improvement seen over a short period of time is encouraging,” the authors wrote.

Zygmont and colleagues also noted that discordant recommendations directly leading to additional imaging decreased from more than 59 percent to more than 49 percent, but that shift was too slight to be considered statistically significant.