Routine Use of Structured Reporting in Whole-body Trauma CT Facilitates Quality Improvement

Abstract

Purpose Structured reporting (SR) is increasingly used. So far, there is minimal experience with SR in whole-body computed tomography (WBCT). The aim of this study was to investigate the value of routine use of SR in WBCT in trauma with a focus on reporting time, reporting errors, and referrer satisfaction.

Materials and Methods Reporting time and reporting errors of CT reports were prospectively quantified for residents and board-certified radiologists 3 months before and for 6 months after implementation of a structured report in the clinical routine. Referrer satisfaction was prospectively quantified by means of a survey before and after the implementation period of SR using a 5-point Likert scale. Before and after results were compared to determine the effect of structured reporting on WBCT in trauma at our institution.

Results The mean reporting time was lower when using SR (65 ± 52 min. vs. 87 ± 124 min., p = .25). After 4 months, the median reporting time was significantly lower with SR (p = .02). Consequently, the rate of reports that were finished within one hour rose from 55.1 % to 68.3 %. Likewise, reporting errors decreased (12.6 % vs. 8.4 %, p = .48). Residents and board-certified radiologists reported fewer errors when using SR with 16.4 % vs. 12.6 % and 8.8 % vs. 2.7 %, respectively. General referrer satisfaction improved (1.7 ± 0.8 vs. 1.5 ± 1.1, p = .58). Referrers graded improvements for standardization of reports (2.2 ± 1.1 vs. 1.3 ± 1.1, p = .03), consistency of report structure (2.1 ± 1.1 vs. 1.4 ± 1.1, p = .09), and retrievability of relevant pathologies (2.1 ± 1.2 vs. 1.6 ± 1.1, p = .32).

Conclusion SR has the potential to facilitate process improvement for WBCT in trauma in the daily routine with a reduction of reporting time and reporting mistakes while increasing referrer satisfaction.

Key Points:

1. SR for WBCT in trauma is feasable in clinical routine.

2. Reporting time in WBCT in trauma decreases by SR.

3. SR for WBCT in trauma has the potential to decrease reporting mistakes.

4. SR for WBCT in trauma might increase referrer satisfaction.

Citation Format

• Blum SF, Hertzschuch D, Langer E et al. Routine Use of Structured Reporting in Whole-body Trauma CT Facilitates Quality Improvement. Fortschr Röntgenstr 2023; 195: 521 – 528

Zusammenfassung

Ziel Die strukturierte Befundung (SR) findet immer breitere Anwendung in der radiologischen Befundung. Bislang gibt es jedoch kaum Erfahrung in der SR der Computertomografie (CT) beim Polytrauma. Studienziel war die Untersuchung des Beitrages der SR zur Polytrauma-CT hinsichtlich Befundungsdauer, Befundungsfehlern und Zuweiserzufriedenheit.

Material und Methoden Die Befundungsdauer und Befundungsfehler der CT-Primärbefunde wurden prospektiv für Weiterbildungsassistenten und Fachärzte 3 Monate vor (ohne SR) sowie in den ersten 6 Monaten nach Einführung der strukturierten Befundung in der klinischen Routine erfasst. Die Zuweiserzufriedenheit wurde mithilfe einer Befragung vor und nach der Einführung mittels 5-stufiger Likert-Skala erfasst. Die Vorher- und Nachher-Ergebnisse wurden verglichen, um den Effekt der SR bei der Polytrauma-CT an einem universitären Haus zu objektivieren.

Ergebnisse Die mittlere Befundungsdauer war mit der SR kürzer (65 ± 52 min vs. 87 ± 124 min, p = 0,25). Nach 4 Monaten war die mediane Befundungszeit mit der SR signifikant geringer (p = 0,02). In der Folge stieg die Rate an Befundberichten, die innerhalb einer Stunde finalisiert wurden von 55,1 % auf 68,3 %. Gleichzeitig sanken die Befundungsfehler (12,6 % vs. 8,4 %, p = 0,48). Sowohl Weiterbildungsassistenten als auch Fachärzte hatten mit SR weniger Befundungsfehler mit 16,4 % vs. 12,6 % beziehungsweise 8,8 % vs. 2,7 %. Die allgemeine Zuweiserzufriedenheit wurde verbessert (1.7 ± 0.8 vs. 1.5 ± 1.1, p = 0,58). Im Detail bewerteten die Zuweiser deutliche Verbesserungen bei Befundstandardisierung (2.2 ± 1.1 vs. 1.3 ± 1.1, p = 0,03), Konsistenz der Befundstruktur (2.1 ± 1.1 vs. 1.4 ± 1.1, p = 0,09) und Auffindbarkeit relevanter Pathologien (2.1 ± 1.2 vs. 1.6 ± 1.1, p = 0,32).

Schlussfolgerung Die SR hat das Potenzial, eine Prozessverbesserung bei der Polytrauma-CT in der täglichen Routine mit Reduktion der Befundungsdauer und Befundungsfehler bei Verbesserung der Zuweiserzufriedenheit zu ermöglichen.

Kernaussagen:

1. SR für die Polytrauma-CT ist in der klinischen Routine möglich.

2. Die Befundungsdauer für die Polytrauma-CT sinkt durch SR.

3. SR für die Polytrauma-CT hat das Potential Befundungsfehler zu senken.

4. SR für die Polytrauma-CT könnte die Zuweisezufriedenheit steigern.

Key words

computed tomography - reporting error - quality improvement - trauma - reporting time - structured reporting

Publikationsverlauf

Eingereicht: 07. September 2022

Angenommen: 27. Januar 2023

Artikel online veröffentlicht:
05. April 2023

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