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UCH Out of Hours Spinal MRI Pathway Audit
EP30666
Poster Title: UCH Out of Hours Spinal MRI Pathway Audit
Submitted on 07 Nov 2019
Author(s): Laura Davis, Tim Hall, Kannan Rajesparan; UCH Imaging Department
Affiliations: UCLH
This poster was presented at BIR Annual Congress 2019
Poster Views: 104
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Poster Information
Abstract:
OBJECTIVE.
To assess a newly-introduced OOHMRI pathway for suspected spinal cord or cauda equina compression at UCLH against local and national standards (NICE; British Associate of Spinal Surgeons).

SUBJECTS AND METHODS.
42 cases (20.6.18-31.12.18); prospective data verified against electronic records (RIS; PACS). Standards (100% compliance): Initial call to radiographer arrival on site <1h; Radiographer arrival to patient arrival in MRI < 30m; Patient arrival to end of first sequence <25m; Scan to first report < 1h.; Referral adequacy.

RESULTS.
Median referral time 21h00 (IQR 20h00-23h00). Median time from initial call to radiographer arrival at hospital: 58min (18-80; 65% compliance). Median time - radiographer on site to patient arrival in MRI: 45min (30-75; 35% compliance). Median interval from patient arrival until end of first sequence: 45min (30-75; 35% compliance). Median time from scan to first report: 37min (21-54, 85% compliance). Delays: 7/42 due to patient transport; 2/42 due to escort; 4/42 no scan request.
5/42 positive cases; all reported expeditiously (median referral to report time 124min; 104-190). ED Senior discussion recorded in 1/4 of referrals. 23/42 written requests were guideline-compliant.
 
CONCLUSION.
Patient transfer from ED to MRI in most cases exceeded 30min standard. Reporting was generally prompt. Pathway modification is required to optimise workflow with introduction of an electronic referral checklist and dedicated porters.

Summary: UCH Out of Hours Spinal MRI Pathway AuditReferences: References:
1. NICE Clinical Guideline 75 (https://www.nice.org.uk/guidance/cg75)
2. British Association of Spinal Surgeons (www.spinesurgeons.co.uk)
3. Spinal Surgery - Getting It Right First Time (https://gettingitrightfirsttime.co.uk/surgical-specialty/spinal-surgery/)
4. British Orthopaedic Association (https://www.boa.ac.uk)
5. Society of British Neurological Surgeons (https://www.sbns.org.uk)
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