Advertisement

CT Practice Management

  • Timothy P. SzczykutowiczEmail author
Chapter

Abstract

Most imaging centers have more than one make and model of CT scanner in use across multiple locations within a hospital, city, or geographical region. These different scanners must fulfill identical imaging requests while often simultaneously realizing local site-specific exams. Many sites have in the hundreds of CT protocols to satisfy the hundreds of order sets a clinical diagnostic CT scanner receives. These clinical and logistical realities make CT protocol management challenging. This chapter defines this problem in more detail. We discuss strategies to address CT protocol management. We define a CT protocol from the perspective of clinical, compliance, workflow, and technical details. We discuss why we need a CT protocol optimization team and team membership. Lastly, we review solutions for documenting CT protocols and disseminating them to one’s CT scanner fleet.

Keywords

CT protocol management Quality management system Cloud Protocol CT protocol optimization team Compliance 

References

  1. 1.
    Boland GW. Enhancing CT productivity: strategies for increasing capacity. Am J Roentgenol. 2008;191(1):3–10.CrossRefGoogle Scholar
  2. 2.
    ACR appropriateness criteria. American College of Radiology Web site. https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria Accessed 23rd Jan 2019.
  3. 3.
    Brunnquell CL, Avey GD, Szczykutowicz TP. Objective evaluation of CT time efficiency in acute stroke response. J Am Coll Radiol. 2018;15(6):876–80.CrossRefGoogle Scholar
  4. 4.
    Szczykutowicz TP, Brunnquell CL, Avey GD, Bartels C, Belden DS, Bruce RJ, Field AS, Peppler WW, Wasmund P, Wendt G. A general framework for monitoring image acquisition workflow in the radiology environment: timeliness for acute stroke CT imaging. J Digit Imaging. 2018;31(2):201–9.CrossRefGoogle Scholar
  5. 5.
    AAPM CT Lexicon Version 1.3. AAPM Web site. https://www.aapm.org/pubs/CTProtocols/documents/CTTerminologyLexicon.pdf Accessed 23rd Jan 2019.
  6. 6.
    TJC The Joint Commission Diagnostic Imaging Standards. https://www.jointcommission.org/assets/1/18/AHC_DiagImagingRpt_MK_20150806.pdf. Retrieved 18th Jan 2019.
  7. 7.
    Szczykutowicz TP, Pozniak M. A team approach for CT protocol optimization. J Assoc Med Imaging Manag Radiol Manag. 2016. Available at http://www.radiologymanagement-digital.com/radiologymanagement/11122016.
  8. 8.
    Szczykutowicz TP, Rubert N, Belden D, Ciano A, Duplissis A, Hermanns A, Monette S, JanssenSaldivar E. A wiki based CT protocol management system. Radiol Manage. 2015;(6):25–9.Google Scholar
  9. 9.
    DICOM. DICOM Supplement 121: CT Protocol Storage. ftp://medical.nema.org/medical/dicom/final/sup121_ft.pdf Accessed 23rd Jan 2019.
  10. 10.
    Szczykutowicz TP, Rubert N, Belden D, Ciano A, Duplissis A, Hermanns A, Monette S, Saldivar EJ. A wiki-based solution to managing your institution’s imaging protocols. J Am Coll Radiol. 2016;13(7):822–4.CrossRefGoogle Scholar
  11. 11.
    Sachs PB, Hunt K, Mansoubi F, Borgstede J. CT and MR protocol standardization across a large health system: providing a consistent radiologist, patient, and referring provider experience. J Digit Imaging. 2017;30(1):11–6.CrossRefGoogle Scholar
  12. 12.
    Cody DD, Fisher TS, Gress DA, Jr RRL, McNitt-Gray MF, Jr RJP, Fairobent LA. AAPM medical physics practice guideline 1. A: CT protocol management and review practice guideline. J Appl Clin Med Phys. 2013;14(5):3–12.CrossRefGoogle Scholar
  13. 13.
    Siegelman JRQW, Gress DA. Radiology stewardship and quality improvement: the process and costs of implementing a CT radiation dose optimization committee in a medium-sized community hospital system. J Am Coll Radiol. 2013;10(6):416–22.CrossRefGoogle Scholar
  14. 14.
    Kofler JM, Cody DD, Morin RL. CT protocol review and optimization. J Am Coll Radiol. 2014;11(3):267–70.CrossRefGoogle Scholar
  15. 15.
    Trattner S, Pearson GD, Chin C, Cody DD, Gupta R, Hess CP, et al. Standardization and optimization of CT protocols to achieve low dose. J Am Coll Radiol. 2014;11(3):271–8.CrossRefGoogle Scholar
  16. 16.
    Szczykutowicz TP, Bour RK, Pozniak M, Ranallo FN. Compliance with AAPM practice Guideline 1. a: CT protocol management and review—from the perspective of a university hospital. J Appl Clin Med Phys. 2015;16(2):443–57.CrossRefGoogle Scholar
  17. 17.
    Szczykutowicz TP, Bour RK, Rubert N, Wendt G, Pozniak M, Ranallo FN. CT protocol management: simplifying the process by using a master protocol concept. J Appl Clin Med Phys. 2015c;16(4):228–43.CrossRefGoogle Scholar
  18. 18.
    Zhang D, Savage CA, Li X, Liu B. Data-driven CT protocol review and management—experience from a large academic hospital. J Am Coll Radiol. 2015;12(3):267–72.CrossRefGoogle Scholar
  19. 19.
    Grimes J, Leng S, Zhang Y, Vrieze T, McCollough C. Implementation and evaluation of a protocol management system for automated review of CT protocols. J Appl Clin Med Phys. 2016;17(5):523–33.CrossRefGoogle Scholar
  20. 20.
    IHE Integrating the Healthcare Enterprise: Management of Acquisition Protocols (MAP). https://www.ihe.net/uploadedFiles/Documents/Radiology/IHE_RAD_Suppl_MAP.pdf. Retrieved 18th Jan 2019.
  21. 21.
    Bohl M, Szczykutowicz T. A challenge to radiology and its professional associations: advocate for the implementation of IHE’s management of acquisition protocols (MAP) profile. Published in the Radiology Business Management Association (RBMA) Bulletin November–December 2018.Google Scholar
  22. 22.
    Szczykutowicz TP, Siegelman J. On the same page—physicist and radiologist perspectives on protocol management and review. J Am Coll Radiol. 2015;12(8):808–14.CrossRefGoogle Scholar
  23. 23.
    Szczykutowicz TP, Malkus A, Ciano A, Pozniak M. Tracking patterns of nonadherence to prescribed CT protocol parameters. J Am Coll Radiol. 2017;14(2):224–30.CrossRefGoogle Scholar
  24. 24.
    Bae KT. Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology. 2010;256(1):32–61.CrossRefGoogle Scholar
  25. 25.
    Kalra MK, Saini S, Rubin GD, editors. MDCT: from protocols to practice. New York: Springer Science & Business Media; 2009. Chapter 2 by KT Bae.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.University of Wisconsin Madison, School of Medicine and Pubic Health Department of RadiologyMadisonUSA

Personalised recommendations