APPROPRIATE CLINICAL PRACTICES, AN APPROACH TO OPTIMIZE CT PULMONARY ANGIOGRAM TIMELINE AND PATIENT CARE

Abstract

PURPOSE: To allow closure of audit loop by re-auditing the timeline for computerized tomography pulmonary angiography (CTPA) and monitor whether or not accepted standards of recommendation are maintained since initial audit.

METHODS: Data from radiology department of SKMCH&RC was collected retrospectively over a three months period and included 124 patients who underwent CTPA. Request time, scan time, time of initial and final reporting was noted. Time elapsed between request to scan and that for scan to report was figured out. Patients were categorized according to their risk for into high, non-high risk and also on into suspected massive and sub-massive pulmonary embolism (PE). Results were compared with the standard guidelines and with the previous audit.

RESULTS: For comparison with the reporting standards, 20 cases turned out high risk and were suspected massive PE, of which 11 were reported within standard time of 30 minutes. For non-high risk and suspected sub-massive PE, 94 presented to EAR and INP department, 89 of which were reported in same working day and all 10 OPD cases were reported by next working day after scanned.  For comparison of time elapsed between request and scan, 4 patients were suspected massive PE, of which 3 were scanned within 1 hour. For suspected sub-massive PE 94 out of 104 cases were scanned with in standard limits of 24 hours.

CONCLUSION: Though results falls very close to recommended standards yet, Re-audit clearly shows no noticeable upgrading changes since the initial audit.

Keywords:  Clinical audit, CT-scan, Time-lapsed imaging, pulmonary thromboembolism.