A quality improvement initiative at Virginia Mason Medical Center has reduced unnecessary imaging referrals for adnexal lesions, according to an article published online in the Journal of the American College of Radiology.
According to the authors, led by Jamie S. Hui, M.D., pelvic ultrasonography is most often used for evaluating gynecological problems. Adnexal cysts are very common findings in pelvic ultrasound, leading to additional--and often unnecessary--imaging.
Consequently, researchers at Virginia Mason Medical Center devised a five-year prospective study consisting of two interventions and three data collection periods used to spearhead a quality improvement initiative.
The first intervention involved giving ultrasound radiologists and sonographers education about unnecessary follow-ups for physiologic or benign adnexal lesions. The second intervention involved implementing the national consensus guideline of adnexal cysts, according to the Society of Radiologists in Ultrasound Consensus statement white paper.
After these interventions, the primary quality outcome the researchers were interested in assessing the proportion on pelvic ultrasound exams in which follow-up was recommended for an adnexal lesion. The reviews performed after each intervention found that while the number of follow-up recommendations decreased, a more significant reduction (58 percent) occurred with the second intervention involving the implementation of the national consensus guideline.
"This reduction implies that radiologists are able to confidently characterize more adnexal lesions as physiologic or benign," wrote Hui and colleagues. "By accepting a standard sonographic imaging reporting process, we reduce variability and thereby improve the quality of our reports."