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2010 QUALITY IMPROVEMENT INITIATIVES

Patient Safety Project: Picture Archiving Communication System (PACS)

Time Frame: 2010 and ongoing

Project Description:
In 2008, a Picture Archiving Communication System (PACS) was installed, linking Grace Cottage Hospital and Brattleboro Memorial Hospital’s Radiology Departments with the goal of a quick turn around time between when a patient is seen by a radiologic technologist and when a radiologist off-site can read the image and send a report back to the hospital.

The same radiologist group interprets images for both Grace Cottage Hospital and Brattleboro Memorial Hospital during normal business hours on-site at Brattleboro Memorial Hospital (BMH).

Problem:
PACS enabled patients seen at either hospital twenty-four hours a day, seven days a week to receive a prompt diagnosis using imaging technology. However the radiologist on-site at BMH could not view images taken at Grace Cottage Hospital on the same workstation as the images taken at BMH. Specialists who wanted to view the Grace Cottage images had to walk from their office to the main hospital to access the images on a dedicated workstation, which caused delays in patient treatment. Images from BMH could be viewed in the specialist’s office, images from GCH could not. In addition, the physician could not determine if prior radiological studies had been taken at BMH when viewing GCH images or if prior studies had been taken at GCH when viewing BMH images. This could potentially contribute to redundancy of radiologic testing for patients.  Patients were requested to bring CDs of their Grace Cottage images to the specialist’s office at BMH so the images taken at Grace Cottage could be viewed during the visit or the patient would be asked to return at another time so the specialist could go to the main hospital to view these images.

Goals:
Goals of this continuing initiative in 2010 were to 1) to allow the radiologist or ordering physician the ability to view radiologic images from either Grace Cottage or BMH on the same workstation,
2) to allow specialists easy access to view images from either hospital or in their office,  
3) to allow the physician the ability to determine what radiological images of a patient had been taken at either hospital.

Intervention Process:
The Information Technology Departments at both hospitals worked collaboratively with the PACS software vendor to have the two different software used at each hospital co-exist on the same workstation and allow the physician viewing the images to go back and forth between Grace Cottage and BMH software systems. This removed the need to access one designated workstation for images originating at Grace Cottage and another workstation for images originating at BMH.

Evaluation:
This initiative contributed to improved timeliness of diagnosis, a reduction in redundancy in diagnostic tests, and improved workflow for the medical practitioners. Patients no longer need to get a CD of images taken at Grace Cottage to bring to specialists at BMH and these same specialists can now view images taken at Grace Cottage in their offices. Future goals of this initiative are to allow physicians the ability to view a historic list of images taken at either hospital on the same workstation and to be able to compare images.