MRI safety system cuts inpatient deterioration events by nearly 80%
A standardized risk assessment for inpatients who require MR imaging can significantly reduce deterioration-related events.
That’s according to a new paper published in Academic Radiology, which details a large health system’s effort to improve care for inpatients undergoing MRI. Inpatient imaging can present unique safety challenges, particularly for those who are critically ill or whose condition may deteriorate during imaging. Researchers sought to determine whether standardized MRI Care Level guidelines and an EHR-integrated dashboard could help identify patients at greater risk and reduce these events by offering staff vital information on their needs during imaging.
Experts involved in developing the guidelines are hopeful their framework could help address MRI safety issues that are less talked about, such as deterioration of condition.
“Inpatients, who are frequently sick and often require monitoring before, during, and after scanning, are at risk of experiencing deterioration of condition events during their lengthy stay in the MRI department,” Jonathan Garner, with the Georgetown University School of Medicine, and colleagues noted. “The inpatient MRI workflow across the hospital system is complex and requires significant coordination between the MRI technologists and the inpatient care team which can lead to inefficiencies."
The study examined inpatient MRI orders and safety events from 2020 through 2024 across nine hospitals. The MRI Care Level system, implemented in November 2022, categorizes patients into three levels based on their risk of deterioration, with care level 3 representing the highest risk patients. The guidelines provide insight into precautions that can be implemented based on each level of care patients require; they offer suggestions for everything from how patients should be positioned based on their medical condition to any additional equipment the patient requires (breathing devices, IV poles, etc.), their mental status and more.
Five of the organization’s nine hospitals adopted the guidelines and dashboard, including one university-affiliated academic hospital and four community hospitals. Overall, 47% of screened MRI orders at participating hospitals were assigned a care level.
At the academic hospital, 58.5% of patients were classified as care level 1, 25.1% as level 2 and 16.4% as level 3. At the community hospitals, 75.5% were level 1, 20.6% were level 2 and 3.9% were level 3. Following implementation, the rate of deterioration events at participating hospitals fell from 2.11 to 0.45 events per 10,000 completed MRI examinations, representing around a 79% reduction. Severe deterioration events resulting in cardiopulmonary resuscitation or death also declined at participating hospitals, falling from 0.20 to 0 events per 10,000 MRIs. These rates increased slightly at the non-participating hospitals.
Researchers suggest that standardized risk stratification, combined with an EMR-integrated tool, may improve the safety of inpatient MRI by helping radiology and clinical teams identify patients who require additional precautions.
“Our data show that the use of MRI CL guidelines as part of the MRI inpatient dashboard could help to substantially reduce DOC safety events,” the authors concluded. “We believe that the MRI CL presented here are generalizable and can be easily adapted to other hospital systems and possibly integrated into other EMRs.”
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.