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

Figures

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  Fig. 1. Patient flow chart. Multidisciplinary conferences (MDC) for a medical and for a surgical intensive care unit (ICU) were introduced at this university hospital in 2018. The MDCs take place twice a week separately for the medical and surgical ICU. Radiologists present recent imaging studies which are then re-interpreted and discussed a second time with the treating ICU physicians. Bilateral feedback is provided and the occurrence of QM events is documented. Standardised protocols of all scheduled MDCs were collected over a 19-month period and analysed with regard to different QM categories and QM consequences. For some days, no MDCs were scheduled due to public holidays (n = 10) or organisational reasons (n = 63)

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  Fig. 2. QM events by category. QM events were categorised into incidents related to indication (n = 8, 5.8%), procedure (n = 25, 18.0%), and reporting (n = 106, 76.3%). The standardised protocol used for documentation of MDCs has a box for entering free text (QM comments), which was used in 658 (67.6%) of all examinations presented in an MDC (n = 973). In examinations affected by QM events, QM comments further addressed and explained the respective event. In examinations not affected by QM events, QM comments provided general feedback for further improvement

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  Fig. 3. Incidence of QM events over time. Each dot represents one MDC at a specific time of the intervention period. The QM incidence (Y-axis) shows the number of QM events per examination presented for each of those MDCs. QM events decreased significantly by 73.6% from the first (n = 109/476) to the second half (n = 30/497) of the intervention period (p < 0.0001) as reflected by the trend line. This significant decrease in QM events over time was confirmed by linear regression (p = 0.0001) after testing for respective requirements