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Showing content from https://pubmed.ncbi.nlm.nih.gov/32933802/ below:

Recover Wisely From COVID-19: Responsible Resumption of Nonurgent Radiology Services

. 2020 Oct;27(10):1343-1352. doi: 10.1016/j.acra.2020.08.002. Epub 2020 Aug 10. Recover Wisely From COVID-19: Responsible Resumption of Nonurgent Radiology Services Mary Mahoney², Jeffrey L Anderson³, Becky Allen³, Joseph Hudepohl², Seetharam Chadalavada², Kyuran A Choe², Sangita Kapur², Mary Gaskill-Shipley², Abouelmagd Makramalla², Ann Brown², Susan Braley², Eric England², Jennifer Scheler², Gavin Udstuen², Frank J Rybicki²

Affiliations

¹ University of Cincinnati, 234, Goodman Street, Cincinnati, Ohio, 45267. Electronic address: vagala@ucmail.uc.edu.
² University of Cincinnati, 234, Goodman Street, Cincinnati, Ohio, 45267.
³ UC Health, Cincinnati, Ohio.

PMID: 32933802
PMCID: PMC7416732
DOI: 10.1016/j.acra.2020.08.002

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Recover Wisely From COVID-19: Responsible Resumption of Nonurgent Radiology Services

Achala Vagal et al. Acad Radiol. 2020 Oct.

. 2020 Oct;27(10):1343-1352. doi: 10.1016/j.acra.2020.08.002. Epub 2020 Aug 10. Authors Achala Vagal¹, Mary Mahoney², Jeffrey L Anderson³, Becky Allen³, Joseph Hudepohl², Seetharam Chadalavada², Kyuran A Choe², Sangita Kapur², Mary Gaskill-Shipley², Abouelmagd Makramalla², Ann Brown², Susan Braley², Eric England², Jennifer Scheler², Gavin Udstuen², Frank J Rybicki² Affiliations

¹ University of Cincinnati, 234, Goodman Street, Cincinnati, Ohio, 45267. Electronic address: vagala@ucmail.uc.edu.
² University of Cincinnati, 234, Goodman Street, Cincinnati, Ohio, 45267.
³ UC Health, Cincinnati, Ohio.

PMID: 32933802
PMCID: PMC7416732
DOI: 10.1016/j.acra.2020.08.002

Item in Clipboard

Abstract

Rationale and objectives: Following state and institutional guidelines, our Radiology department launched the "Recover Wisely" for all nonurgent radiology care on May 4, 2020. Our objective is to report our practice implementation and experience of COVID-19 recovery during the resumption of routine imaging at a tertiary academic medical center.

Materials and methods: We used the SQUIRE 2.0 guidelines for this practice implementation. Recover Wisely focused on a data driven, strategic rescheduling and redesigning patient flow process. We used scheduling simulations and meticulous monitoring and control of outpatient medical imaging volumes to achieve a linear restoration to our pre-COVID imaging studies. We had a tiered plan to address the backlog of rescheduled patients with gradual opening of our imaging facilities, while maintaining broad communication with our patients and referring clinicians.

Results: Recover Wisely followed our anticipated linear modeling. Considering the last 10 weeks in the recovery, outpatient growth was linear with an increase of approximately 172 cases per week, (R² =0.97). We achieved an overall recovery of 102% in week 10, as compared to average weekly pre-COVID outpatient volumes. The modalities recovered as follows in outpatient volumes: CT (113%), MRI (101%), nuclear medicine including PET (138%), mammograms (97%), ultrasound (99%) and interventional radiology (106%). When compared to identical 2019 calendar weeks (May 4, 2020-July 10, 2020), the total 2020 radiology volume was 11% reduced from the 2019 volume. The reduction in total weighted relative value units was 8% in this time period, as compared to 2019.

Conclusion: Our department utilized a data-driven, team approach based on our guiding principles to "Recover Wisely." We created and implemented a methodology that achieved a linear increase in outpatient studies over a 10-week recovery period.

Keywords: COVID-19; Radiology department; Recovery.

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Conflict of interest statement

Conflicts of Interests AV: R01 NIH/NINDS NS103824-01; R01 NIH/NINDS NS100417; NIH/NINDS 1U01NS100699; NIH/NINDS U01NS110772; Imaging Core Lab, ENDOLOW Trial, Cerenovus, Johnson & Johnson; Human centered design grant, ACR Innovation Fund. FR: Director of Medical Affairs at Imagia. MM: RSNA BOD, ACR BOC, Nonfinancial support from GE research agreement, Personal fees from Elsevier. JA, BA, JH, SC, KC, SK, MG, AM, AB, SB, EE, JS, GU: No conflicts to disclose

Figures
Figure 1

Process map for recover wisely.

Figure 1

Process map for recover wisely.

Figure 1

Process map for recover wisely.

Figure 2

Snapshot of query of radiology…

Figure 2

Snapshot of query of radiology scheduling database using electronic medical record.

Figure 2

Snapshot of query of radiology scheduling database using electronic medical record.

Figure 3

Patient communication letter.

Figure 3

Patient communication letter.

Figure 3

Patient communication letter.

Figure. 4

Total radiology volumes in different…

Figure. 4

Total radiology volumes in different settings of outpatient, inpatient and emergency department.

Figure. 4

Total radiology volumes in different settings of outpatient, inpatient and emergency department.

Figure 5

Total radiology volumes in different…

Figure 5

Total radiology volumes in different modalities.

Figure 5

Total radiology volumes in different modalities.

Figure 6

Linear recovery for outpatient volumes…

Figure 6

Linear recovery for outpatient volumes in recovery weeks. Weekly volumes were normalized to…

Figure 6

Linear recovery for outpatient volumes in recovery weeks. Weekly volumes were normalized to account for holidays where outpatients were not scheduled.