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Showing content from https://pubmed.ncbi.nlm.nih.gov/32473108/ below:

Rescheduling Nonurgent Care in Radiology: Implementation During the Coronavirus Disease 2019 (COVID-19) Pandemic

. 2020 Jul;17(7):882-889. doi: 10.1016/j.jacr.2020.05.010. Epub 2020 May 19. Rescheduling Nonurgent Care in Radiology: Implementation During the Coronavirus Disease 2019 (COVID-19) Pandemic Mary Mahoney², Becky Allen³, Sangita Kapur⁴, Gavin Udstuen⁵, Lily Wang⁶, Susan Braley⁷, Abouelmagd Makramalla⁸, Seetharam Chadalavada⁹, Kyuran A Choe¹⁰, Jennifer Scheler¹¹, Ann Brown¹², Eric England¹³, Joseph Hudepohl¹⁴, Frank J Rybicki¹⁵

Affiliations

¹ Vice Chair Research, Department of Radiology, University of Cincinnati, Cincinnati, Ohio. Electronic address: vagala@ucmail.uc.edu.
² Department Chair, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
³ Enterprise Director of Imaging, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁴ Section Chief, Chest, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁵ Director, Outpatient Imaging, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁶ Neuroradiology Fellowship Director, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁷ Section Chief, Musculoskeletal, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁸ Section Chief, Interventional Radiology, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁹ Vice Chair of Informatics, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹⁰ University of Cincinnati and University of Cincinnati Physicians, Inc, Cincinnati, Ohio.
¹¹ Section Chief, Nuclear medicine, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹² Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹³ Vice Chair, Education, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹⁴ Executive Business Director, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹⁵ Vice Chair of Operations, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.

PMID: 32473108
PMCID: PMC7236746
DOI: 10.1016/j.jacr.2020.05.010

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Rescheduling Nonurgent Care in Radiology: Implementation During the Coronavirus Disease 2019 (COVID-19) Pandemic

Achala Vagal et al. J Am Coll Radiol. 2020 Jul.

. 2020 Jul;17(7):882-889. doi: 10.1016/j.jacr.2020.05.010. Epub 2020 May 19. Authors Achala Vagal¹, Mary Mahoney², Becky Allen³, Sangita Kapur⁴, Gavin Udstuen⁵, Lily Wang⁶, Susan Braley⁷, Abouelmagd Makramalla⁸, Seetharam Chadalavada⁹, Kyuran A Choe¹⁰, Jennifer Scheler¹¹, Ann Brown¹², Eric England¹³, Joseph Hudepohl¹⁴, Frank J Rybicki¹⁵ Affiliations

¹ Vice Chair Research, Department of Radiology, University of Cincinnati, Cincinnati, Ohio. Electronic address: vagala@ucmail.uc.edu.
² Department Chair, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
³ Enterprise Director of Imaging, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁴ Section Chief, Chest, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁵ Director, Outpatient Imaging, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁶ Neuroradiology Fellowship Director, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁷ Section Chief, Musculoskeletal, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁸ Section Chief, Interventional Radiology, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
⁹ Vice Chair of Informatics, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹⁰ University of Cincinnati and University of Cincinnati Physicians, Inc, Cincinnati, Ohio.
¹¹ Section Chief, Nuclear medicine, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹² Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹³ Vice Chair, Education, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹⁴ Executive Business Director, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.
¹⁵ Vice Chair of Operations, Department of Radiology, University of Cincinnati, Cincinnati, Ohio.

PMID: 32473108
PMCID: PMC7236746
DOI: 10.1016/j.jacr.2020.05.010

Item in Clipboard

Abstract

Objective: To meet hospital preparedness for the coronavirus disease 2019 pandemic, the Centers for Disease Control and Prevention and ACR recommended delay of all nonemergent tests and elective procedures. The purpose of this article is to report our experience for rescheduling nonemergent imaging and procedures during the pandemic at our tertiary academic institution.

Methods: We rescheduled the nonemergent imaging and procedures in our hospitals and outpatient centers from March 16 to May 4, 2020. We created a tiered priority system to reschedule patients for whom imaging could be delayed with minimal clinical impact. The radiologists performed detailed chart reviews for decision making. We conducted daily virtual huddles with discussion of rescheduling strategies and issue tracking.

Results: Using a snapshot during the rescheduling period, there was a 53.4% decrease in imaging volume during the period of March 16 to April 15, 2020, compared with the same time period in 2019. The total number of imaging studies decreased from 38,369 in 2019 to 17,891 in 2020 during this period. Although we saw the largest reduction in outpatient imaging (72.3%), there was also a significant decrease in inpatient (40.5%) and emergency department (48.9%) imaging volumes.

Discussion: The use of multiple communication channels was critical in relaying the information to all our stakeholders, patients, referring physicians, and the radiology workforce. Teamwork, quick adoption, and adaptation of changing strategies was important given the fluidity of the situation.

Keywords: COVID-19; nonurgent care; rescheduling.

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Figures
Fig 1

High-level process map for rescheduling…

Fig 1

High-level process map for rescheduling non-emergent imaging studies. COVID 2019 = coronavirus disease…

Fig 1

High-level process map for rescheduling non-emergent imaging studies. COVID 2019 = coronavirus disease 2019; DXA = Dual-energy X-ray absorptiometry.

Fig 2

Electronic medical record notification to…

Fig 2

Electronic medical record notification to provider about rescheduling radiology examination because of coronavirus…

Fig 2

Electronic medical record notification to provider about rescheduling radiology examination because of coronavirus disease 2019 (COVID-19). UC = University of Cincinnati.

Fig 3

Interventional radiology (IR) process map…

Fig 3

Interventional radiology (IR) process map for rescheduling. APP = advanced practice provider, Pt…

Fig 3

Interventional radiology (IR) process map for rescheduling. APP = advanced practice provider, Pt = patient.

Fig 4

Decrease in the imaging volumes…

Fig 4

Decrease in the imaging volumes and relative value units during rescheduling. MAMMO =…

Fig 4

Decrease in the imaging volumes and relative value units during rescheduling. MAMMO = mammography; US = ultrasound; wRVU = weighted relative value units.