The new prevention system effectively decreases the number of unchecked radiological reports

Abstract

The purpose of this clinical research is to clarify the effectiveness of our system to decrease the number of unchecked radiological reports.

Our system is composed of three steps. First, if the radiologist finds unexpected abnormality in an organ different from the purpose of the test, the radiological report is printed out. Second, this radiological report is handed to the medical safety manager and is brought to the chief medical safety manager. Third, the chief medical safety manager will check whether the doctor has explained the unexpected findings to the patients. If the doctor does not explain, the chief medical safety manager will prompt them to explain.

During the study period (November 2017 to September 2019), 33,970 CT examinations were performed and 132 showed unexpected findings. Forty-one of 132 cases were unchecked by the doctors who ordered radiological examination. The rate of unchecked radiological report number during the late term after starting our system (November 2018 〜 September 2019) significantly decreased than in the early term (November 2017 〜 October 2018) (21.5% vs 45.3%, respectively. p=0.0068). According to hearing survey from the radiologists and the medical safety managers, they had experienced 4 to 5 such cases a week, thus this system did not force overload to them.

In this study, our prevention system showed definitive effectiveness in decreasing the rate of unchecked radiological reports. We consider our system to be a promising tool for preventing medical accidents.