Quality is a high priority for Emory Healthcare and Emory Radiology has been at the forefront withinitiatives that continually improve the patient experience. Vice Chair for Quality Marta Heilbrun, MD, MS, is building on a strong foundation laid by Chief Quality Officer Phuong-Anh Duong, MD, who continues to lead several projects, and Quality Program Manager Pratik Rachh, MD. Joining them in a new role is Enterprise Manager of Quality in Imaging Services Susan Reich, a diagnostic radiologic technologist, and diagnostic medical sonographer by training who also holds advanced certification and training in process improvement.
Quality and Uniform Reporting
One recent advancement is the recent rollout of new streamlined, uniform reporting templates in Powerscribe. These templates are used by radiologists to document their findings or interpretations of imaging studies. The reports then transmit to referring physicians who may share the report with patients during clinical visits or through the Emory Patient Portal. A standard format makes it easier for both referring physicians and their patients to access and understand the information which then helps improve the quality of care.
“Radiologists from all of our clinical divisions had to be involved in creating the best looking and most useful templates,” Dr. Heilbrun explains. “It was important for clinical divisions with crossover activity to collaborate on common templates for imaging studies they both might interpret so our referring physicians see a consistent report product.”
For example, Emergency and Trauma Imaging, Neuroradiology, and Community Imaging who all interpret head CTs, collaborated on a template for head CT reports. They had to consider more than the look.
“Not only is a common structure—the order of the information, what headers are capitalized or lower-cased—important, so, too, is a common language,” says Dr. Heilbrun. “What words are we using to describe findings? We need to ensure uniformity in wording and terminology.”
A robust governance committee comprising faculty from all clinical divisions and locations has been essential: each member of the committee solicited feedback from their colleagues within the department and among referring physicians. At the same time, the project depended on the leadership of Vice Chair for Informatics Nabile Safdar, MD, Vice Chair for Policy Richard Duszak, MD, and Vice Chair for Clinical Care Amit Saindane, MD, as well as the Quality team. Together, they built the organizational and technical infrastructure necessary for project success.
The next step involves fine tuning templates based on user feedback. The following faculty have been designated as division point-persons for receiving feedback:
Abdominal Radiology: Deb Baumgarten & Peter Harri
Cardiothoracic: Adam Bernheim
CRS: Paul Harkey & Ray Higginbotham
ETI: Tarek Hanna
IR: John Martin
MSK: Monica Umpierrez & Walt Carpenter
Neuroradiology: Amit Saindane
Nuclear Medicine: Dan Lee
Quality and Emory Edge
The divisions of Quality and Informatics also are involved with platform development of a daily patient care management system approach called Emory Edge, which is part of the $25 million James Cox Kennedy Initiative for Patient-centered Care. The Kennedy Initiative aims to improve the patient experience and the quality of patient across the Emory Healthcare enterprise. Team members are working to ensure Emory Radiology’s informatics systems can integrate with Emory Edge.
Dr. Heilbrun will discuss the implementation of Emory Edge during Emory Radiology Grand Rounds in May. Employee engagement surveys also are planned to understand how various modules can help ensure Emory Radiology provides the best patient care possible.
Quality and Awards
The Quality Division produces high-quality work. At Emory’s 2018 Quality Conference, Susan Reich won 1st prize for Best Overall Poster with the project “Reducing Patient Delays in Radiology and Optimizing On-Time Starts for CT Procedures.” Nathan O. Spell III, vice chair for quality and clinical effectiveness in the School of Medicine praised the project, saying “it contained all of the elements the judges were looking for in a process improvement project.” This award includes a feature in the April issue of Health Sciences Update.
“It’s a huge accomplishment to win Best Overall Poster for the second consecutive year,” says Reich. “It demonstrates why we are fast becoming the leader in quality in health care here at Emory and nationally. ”Pratik Rachh built on his 2017 win for Best Overall Poster by earning this year’s only honor for an oral presentation.
He delivered his presentation, “From Improvement to Implementation Model for Spread of Urgent Chest X-ray Protocols Across EHC ICUs,” with trademark precision and authority. He also won this year’s award for Outstanding Education Intervention with his “Call to Order” poster.
Quality and Diversity
Quality also has an important role to play with respect to diversity. Quality depends on diversity and diversity thrives on quality.
“One of the critical, underlying pieces of quality and continuous process improvement is engagement of multiple stakeholders and perspectives,” Dr. Heilbrun says. “We have an incredibly diverse workforce but don’t always have the means to give everyone voice in decision making, to ensure we hear voices we haven’t been hearing. If people from diverse backgrounds know their opinions are valued, sought, and respected, they will feel encouraged to engage and invest their best professional selves in Emory Radiology.”
Quality Opportunities for Learning
The Quality team invites Emory Radiology colleagues to learn more at these upcoming Grand Rounds:
April 11 – Daily Readiness Huddles: Are You Ready? Presentation by Phuong-Anh Duong, MD,Associate Professor and Chief Quality Officer
May 16 – Emory Edge and Radiology Presentation by Marta Heilbrun, MD, MS, Associate Professor and Vice Chair for Quality