CANANDAIGUA – Results of an innovative quality improvement program developed at UR Medicine’s Thompson Health were recently published in the American Journal of Roentgenology, a peer-reviewed radiology journal with a worldwide circulation of nearly 25,000. Called “Backstop,” the Thompson program helps ensure patients with potentially serious conditions receive appropriate, timely follow-up care.
The study, entitled “Reducing Delay in Diagnosis: Multistage Recommendation Tracking,” is featured in the July 25 issue of the publication. It was authored by Thompson Health Chief of Diagnostic Imaging Dr. Ben Wandtke and Sarah Gallagher, the former quality improvement coordinator at Thompson and now regional neurosurgical stroke coordinator at the University of Rochester Medical Center.
In 2015, the two set out to determine whether a multistage tracking system could improve communication between healthcare providers, reducing the risk of delay in diagnosis related to inconsistent communication and tracking of radiology follow-up recommendations. The initiative centered on “incidental findings,” such as a lung nodule detected when a patient had a CT scan for x-ray for another reason, like chest pain. While many incidental findings will cause patients no harm, others can represent early stages of cancer.
Wandtke and Gallagher led a team that entered recommendations into a database and identified which patients did not obtain the recommended follow-up care. Via a multi-step process involving calls and letters performed by Aubry Parker, the program’s clinical coordinator, Thompson was able to dramatically improve patient compliance with recommendations.
“We want to ensure patients do not ‘fall through the cracks’ by reducing the risk of delay in diagnosis, a form of preventable medical error,” Wandtke said. “Reducing delay in diagnosis ensures that serious medical conditions are identified when they are more easily treatable, improving patient outcomes.”
Over the course of 13 months, completion of recommended follow-up increased by 52 percent for patients tracked in the Backstop program. The number of patients at risk for delay in diagnosis was reduced by 74 percent.
Thompson now identifies appropriate follow-up compliance for more than 86 percent of all radiology recommendations, higher than any other health system has reported in medical literature.
For some patients, Wandtke said, the impact of timely follow-up care can be profound.
“Diagnosing cancer in an early stage compared to a late stage can increase a patient’s chance for successful treatment by 50 percent,” he said. “We feel strongly that every cancer patient deserves their best chance for a cure. This is what motivates my team to go the extramile for the patients who choose UR Medicine’s Thompson Health for their
imaging.”
Wandtke and Gallagher, whose work was supported in part by a risk-reduction award from UR Medicine insurance provider MCIC Vermont, previously presented their results at the 2016 Radiological Society of North America annual meeting, at a quality symposium at Stanford University, and at the 2017 annual meeting of the American College of
Radiology.
Beginning this month, Dr. Wandtke is leading a team comprised of primary care providers, oncologists, radiologists and healthcare quality specialists to expand the Backstop program throughout the network of UR Medicine’s affiliated hospitals. This expansion will increase the number of patients benefiting from this quality initiative tenfold, according to Wandtke.
In the future, he said, the multi-stage tracking model developed at Thompson could be modified to be used for other applications, expanding into pathology or cardiology follow-up tracking, for example.