Imaging intensive care patients: multidisciplinary conferences as a quality improvement initiative to reduce medical error

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Abstract

Background

Strategies to identify imaging-related error and minimise its consequences are important in the management of critically ill patients. A new quality management (QM) initiative for radiological examinations has been implemented in an intensive care unit (ICU) setting. In regular multidisciplinary conferences (MDCs), radiologists and ICU physicians re-evaluate recent examinations. Structured bilateral feedback is provided to identify errors early. This study aims at investigating its impact on the occurrence of QM events (imaging-related errors). Standardised protocols of all MDCs from 1st of June 2018 through 31st of December 2019 were analysed with regard to categories of QM events (i.e. indication, procedure, report) and resulting consequences.

Results

We analysed 241 MDCs with a total of 973 examinations. 14.0% ( n = 136/973) of examinations were affected by QM events. The majority of events were report-related (76.3%, n = 106/139, e.g. misinterpreted finding), followed by procedure-related (18.0%, n = 25/139, e.g. technical issue) and indication-related events (5.8%, n = 8/139, e.g. faulty indication). The median time until identification of a QM event (time to MDC) was 2 days (interquartile range = 2). Comparing the first to the second half of the intervention period, the incidence of QM events decreased significantly from 22.9% ( n = 109/476) to 6.0% ( n = 30/497) ( p < 0.0001). Significance of this effect was confirmed by linear regression ( p < 0.0001).

Conclusions

Establishing structured discussion and feedback between radiologists and intensive care physicians in the form of MDCs is associated with a statistically significant reduction in QM events. These results indicate that MDCs may be one suitable approach to timely identify imaging-related error.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13244-022-01313-5.

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Most cited references 30

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Author and article information

Contributors

Gloria Muench:

ORCID: http://orcid.org/0000-0003-1652-5146

gloria.muench@charite.de

Journal

Journal ID (nlm-ta): Insights Imaging

Journal ID (iso-abbrev): Insights Imaging

Title: Insights into Imaging

Publisher: Springer Vienna (Vienna )

ISSN (Electronic): 1869-4101

Publication date (Electronic): 4 November 2022

Publication date PMC-release: 4 November 2022

Publication date Collection: December 2022

Volume: 13

Electronic Location Identifier: 175

Affiliations

[1 ]Department of Radiology, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany

[2 ]Department of Cardiology, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany

[3 ]GRID grid.6363.0, ISNI 0000 0001 2218 4662, Institute of Biometry and Clinical Epidemiology, , Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, ; Charitéplatz 1, 10117 Berlin, Germany

[4 ]GRID grid.484013.a, ISNI 0000 0004 6879 971X, Berlin Institute of Health (BIH), ; Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany

[5 ]Department of Surgery with Intensive Care, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany

[6 ]GRID grid.6363.0, ISNI 0000 0001 2218 4662, Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), , Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, ; Berlin, Germany

[7 ]GRID grid.6363.0, ISNI 0000 0001 2218 4662, Department of Nephrology and intensive care, Campus Charité Mitte, , Charité – Universitätsmedizin Berlin, Freie Universitäts Berlin and Humboldt Universität zu Berlin, ; Charitéplatz 1, 10117 Berlin, Germany

Author information

Gloria Muench http://orcid.org/0000-0003-1652-5146

Article

Publisher ID: 1313

DOI: 10.1186/s13244-022-01313-5

PMC ID: 9636350

PubMed ID: 36333572

SO-VID: 17d832d4-3a50-4ff5-b1d2-78e2d938c35c

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 23 May 2022

Date accepted : 11 October 2022

Funding

Funded by: Charité - Universitätsmedizin Berlin (3093)

Open Access :

Open Access funding enabled and organised by Projekt DEAL.

Custom metadata

ScienceOpen disciplines: Radiology & Imaging

Keywords: quality improvement,intensive care units,critical care,interdisciplinary communication,feedback

Data availability:

ScienceOpen disciplines: Radiology & Imaging

Keywords: quality improvement, intensive care units, critical care, interdisciplinary communication, feedback

Imaging intensive care patients: multidisciplinary conferences as a quality improvement initiative to reduce medical error

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Background

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Supplementary Information

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Most cited references 30

International study of the prevalence and outcomes of infection in intensive care units.

Human error: models and management.

Gender-related differences in intensive care: a multiple-center cohort study of therapeutic interventions and outcome in critically ill patients.

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