Lead aprons: how protected are you?

No. 305 Influence of a self-reporting metric (SRM) on IR physicians’ documentation of adverse events and complications B. Janne d’Othee, Z. Haskal, A. Rodgers, H.M. Richard, III, B. Iliescu; Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD Purpose: To evaluate a new metric aiming at improved reporting of adverse events (AEs) by multiple IR physicians in a large academic practice. Materials and Methods: After patient discharge from hospital, some AEs, including complications from IR procedures, may be lost to follow-up despite best efforts by IR teams to capture them. Other AEs can be discovered during inpatient stay or subsequent outpatient clinic visits but are not guaranteed to become recorded in IR procedural databases, resulting in a missed opportunity for AE documentation. In this IRB-waivered study, we developed the self-reporting metric (SRM) to reduce this potential problem. SRM is the ratio of the number of AEs that our IR quality assurance (QA) officer is notified of directly by primary operators, divided by the total number of AEs eventually captured in the monthly QA/MM r2 0.94). We are currently moving to systematic recording of AEs during our daily inpatients follow-up rounds. SRM is purely quantitative and does not address the severity and consequences of complications. Individual SRM can be calculated for each attending in the practice and used as a QA tool. It is easily applicable to nonacademic IR practices. Conclusion: SRM is a feasible, easy-to-implement tool that seems to improve over time the reporting and documentation rates of those AEs that are easily discoverable within an IR practice. Educational Exhibit Abstract No. 306 Value based health care delivery: a novel framework for interventional radiology R.W. Liu; Division of Vascular Imaging and Intervention, Massachusetts General Hospital, Boston, MA Learning Objectives: 1) Summarize current challenges to efficient health care delivery. 2) Introduce the framework of value based health care delivery. 3) Demonstrate the application of value based health care delivery to interventional radiology. Background: Health care delivery has several challenges including low access to care, high costs, and variable quality. Causes include competition at the wrong geographic and temporal level and zero sum competition amongst stakeholders. Past attempts at health care reform have failed with a focus to reduce costs and improve processes without an improvement in true outcomes. Recently, Michael Porter of Harvard Business School has introduced the concept of value based health care delivery as a framework to ensure an efficient health care system. Clinical Findings/Procedure Details: Value in health care must be patient centered, defined by outcomes relative to costs. Outcomes must be medical condition specific, and should be measured for the entire disease spectrum such as peripheral arteS124 Poster Sessions JVIR Po st er Se ss io ns rial disease. The outcomes can be categorized into a 3 tier system, encompassing achievement of health status, recovery status, and sustainability of health. Costs should be measured over a longer time frame (years), ensuring that increased spending on certain services can reduce overall costs. Capturing high value may require integrated health care systems, including all multidisciplinary services related to a disease. It is within this novel framework that IR may compete in the future. Interventionalists will continue the trend of joining interdisciplinary teams such as oncology. IR physicians will undergo a cultural shift of measuring outcomes and amortizing costs over an extended time span. As payors adapt to a value based health care delivery system, reimbursement will be tied to enhancing value over a longitudinal cycle. Conclusion and/or Teaching Points: The current health care system is likely unsustainable, requiring a paradigm shift to deliver efficient health care in the future. Value based heath care delivery represents a novel framework whereby disease specific outcomes and costs are measured over an extended time frame. IR may be forced to successfully shift into integrated delivery systems with value based reimbursement over a longer care cycle. Educational Exhibit Abstract No. 307 Patient safety in interventional radiological procedures: safety protocols and checklists M. Mikhail, S. Athreya; McMaster University Michael G. DeGroote School of Medicine, Hamilton, ON, Canada; Department of Diagnostic Imaging, St Joseph’s Healthcare, Hamilton, ON, Canada; Department of Radiology, McMaster University, Hamilton, ON, Canada Learning Objectives: To discuss the importance of safety protocols in promoting team communication and adherence to best safety practices in interventional radiological procedures. To incorporate the World Health Organization guidelines for safe surgery into radiological practice. To discuss strategies for developing patient-centered safety guidelines that are adaptable to the variety of interventional radiological procedures performed. To present a novel safety checklist adopted by the Interventional Radiology team at our center. Background: The use of safety checklists in surgery is well established. Checklists provide the potential of standardizing workflow, empowering team members, creating a culture of vigilance and enabling two way communication. Despite the minimally invasive nature of interventional radiology, the increasing complexity of interventional radiology cases, as well as the importance of ensuring radiation safety for both the patient and team members, necessitates the use of checklists in interventional radiology. Clinical Findings/Procedure Details: We present our center’s experience in implementing a checklist for interventional radiology procedures. The checklist, designed and used by interventional radiologists, technologists and nurses, was adapted from the World Health Organization’s Safe Surgery Checklist. The checklist is routinely used for all interventional radiological procedures, scanned into the PACS system post-procedure and is under regular audit to ensure data input and compliance with checklist procedures. Conclusion and/or Teaching Points: Checklists are efficient means of reducing error in fast paced, complex environments. Their use is particularly relevant in Interventional Radiology. Centers implementing checklists must ensure the entire team’s support to ensure compliance. Users must continuously reassess work flow and adapt their checklists accordingly. Educational Exhibit Abstract No. 308 How to discuss patient radiation risks associated with interventional radiology procedures P.S. Mok, M.O. Baerlocher, D.K. Rajan; Medical Imaging, University of Toronto, Toronto, ON, Canada; Interventional Radiology, Royal Victoria Hospital, Barrie, ON, Canada Learning Objectives: 1. To educate interventional radiologists on potential methods to discuss radiation risks with patients 2. To provide an easy-to-use template consent form for interventional radiologists to discuss radiation risks with patients Background: Radiation exposure has become an important topic in prominent medical journals and social media [1]. Interventional radiologists (IRs) are involved with many procedures that use fluoroscopy and CT guidance that involve radiation exposure to themselves, technologists, nurses, and most of all, patients. There are small, but not insignificant risks to skin, eyes, other organs, and developing ionizing radiation associated cancer [2]. A standardized consent form would make the consent process easier and more time efficient for IRs while ensuring patients are provided with the necessary information to make informed decisions. Clinical Findings/Procedure Details: A template consent form could be given to all referring physicians and interventional radiologists to discuss radiation risks involved in IR procedures. This easy-to-use consent form serves a dual purpose: (1) to educate patients on radiation risks, and (2) to document that radiation risks were explained to the patients. Furthermore, IRs can also use a variety of methods to educate patients on radiation risks, including developing pamphlets, directing patients to relevant online resources such as the website of the Society of Interventional Radiology (www.sirweb.org), and educating referring physicians on radiation risks through presentations at their annual meetings and publishing articles on radiation risks in their journals. Conclusion and/or Teaching Points: Interventional radiologists should consider routinely obtaining informed consent for their IR procedures. IRs are encouraged to use the suggested standardized easy-to-use template consent form to discuss radiation risks with patients. In addition, a variety of methods can be used by interventional radiologists to discuss radiation risks with patients.