An audit of elective outpatient magnetic resonance imaging in a tertiary South African public-sector hospital
Background: Increasing demand for magnetic resonance imaging (MRI) has resulted in longer waiting times for elective MRI, particularly in resource-limited healthcare environments.However, inappropriate imaging requests may also contribute to prolonged MRI waiting times. At the time of the present st...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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AOSIS
2014-12-01
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| Series: | South African Journal of Radiology |
| Online Access: | https://sajr.org.za/index.php/sajr/article/view/689 |
| _version_ | 1811239781868240896 |
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| author | Francois van Schouwenburg Christelle Ackermann Richard Pitcher |
| author_facet | Francois van Schouwenburg Christelle Ackermann Richard Pitcher |
| author_sort | Francois van Schouwenburg |
| collection | DOAJ |
| description | Background: Increasing demand for magnetic resonance imaging (MRI) has resulted in longer waiting times for elective MRI, particularly in resource-limited healthcare environments.However, inappropriate imaging requests may also contribute to prolonged MRI waiting times. At the time of the present study, the waiting time for elective MRI studies at Tygerberg Hospital (TBH), a tertiary-level public-sector healthcare facility in Cape Town (South Africa),was 24 weeks.
Objectives: To document the nature and clinical appropriateness of scheduled TBH outpatient MRI examinations.
Method: A retrospective analysis of the referral forms of all elective outpatient MRIexaminations scheduled at TBH from 01 June to 30 November 2011 was conducted. Patient age, gender, clinical details, provisional diagnosis, examination requested and referring clinician were recorded on a customised data sheet. Two radiologists independently evaluated the appropriateness of each request by comparing the clinical details and the provisional diagnosis provided with the 2012 American College of Radiology (ACR) guidelines for the appropriate use of MRI.
Results: Four hundred and sixty-six patients (median age 42 years; interquartile range 19–55) who had 561 examinations were scheduled in the review period; 70 (15%) were children less than 6 years old. Neurosurgery (n = 164; 35%), orthopaedic (n = 144; 31%),neurology (n = 53; 11%) and paediatric (n = 27; 6%) outpatients accounted for the majority(81%) of referrals; 464 (99.6%) were from specialist clinics. MRIs of the spine (n = 314; 56%),brain (n = 152; 27%) and musculoskeletal system (n = 70, 13%) accounted for more than 95%of the investigations. In 455 cases (98%), the referral was congruent with published ACR guidelines for appropriate MRI utilisation.
Conclusion: Scheduled outpatient MRI examinations at TBH reflect optimal clinical use of a limited resource. MRI utilisation is largely confined to traditional neuro-imaging. Any initiative to decrease the elective MRI waiting time should focus on service expansion. |
| first_indexed | 2024-04-12T13:07:11Z |
| format | Article |
| id | doaj.art-83e6266483f5457e9f4197d1a55e2c76 |
| institution | Directory Open Access Journal |
| issn | 1027-202X 2078-6778 |
| language | English |
| last_indexed | 2024-04-12T13:07:11Z |
| publishDate | 2014-12-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Journal of Radiology |
| spelling | doaj.art-83e6266483f5457e9f4197d1a55e2c762022-12-22T03:31:59ZengAOSISSouth African Journal of Radiology1027-202X2078-67782014-12-01181e1e510.4102/sajr.v18i1.689604An audit of elective outpatient magnetic resonance imaging in a tertiary South African public-sector hospitalFrancois van Schouwenburg0Christelle Ackermann1Richard Pitcher2Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Tygerberg Hospital and Stellenbosch University, South AfricaDivision of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Tygerberg Hospital and Stellenbosch University, South AfricaDivision of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Tygerberg Hospital and Stellenbosch University, South AfricaBackground: Increasing demand for magnetic resonance imaging (MRI) has resulted in longer waiting times for elective MRI, particularly in resource-limited healthcare environments.However, inappropriate imaging requests may also contribute to prolonged MRI waiting times. At the time of the present study, the waiting time for elective MRI studies at Tygerberg Hospital (TBH), a tertiary-level public-sector healthcare facility in Cape Town (South Africa),was 24 weeks. Objectives: To document the nature and clinical appropriateness of scheduled TBH outpatient MRI examinations. Method: A retrospective analysis of the referral forms of all elective outpatient MRIexaminations scheduled at TBH from 01 June to 30 November 2011 was conducted. Patient age, gender, clinical details, provisional diagnosis, examination requested and referring clinician were recorded on a customised data sheet. Two radiologists independently evaluated the appropriateness of each request by comparing the clinical details and the provisional diagnosis provided with the 2012 American College of Radiology (ACR) guidelines for the appropriate use of MRI. Results: Four hundred and sixty-six patients (median age 42 years; interquartile range 19–55) who had 561 examinations were scheduled in the review period; 70 (15%) were children less than 6 years old. Neurosurgery (n = 164; 35%), orthopaedic (n = 144; 31%),neurology (n = 53; 11%) and paediatric (n = 27; 6%) outpatients accounted for the majority(81%) of referrals; 464 (99.6%) were from specialist clinics. MRIs of the spine (n = 314; 56%),brain (n = 152; 27%) and musculoskeletal system (n = 70, 13%) accounted for more than 95%of the investigations. In 455 cases (98%), the referral was congruent with published ACR guidelines for appropriate MRI utilisation. Conclusion: Scheduled outpatient MRI examinations at TBH reflect optimal clinical use of a limited resource. MRI utilisation is largely confined to traditional neuro-imaging. Any initiative to decrease the elective MRI waiting time should focus on service expansion.https://sajr.org.za/index.php/sajr/article/view/689 |
| spellingShingle | Francois van Schouwenburg Christelle Ackermann Richard Pitcher An audit of elective outpatient magnetic resonance imaging in a tertiary South African public-sector hospital South African Journal of Radiology |
| title | An audit of elective outpatient magnetic resonance imaging in a tertiary South African public-sector hospital |
| title_full | An audit of elective outpatient magnetic resonance imaging in a tertiary South African public-sector hospital |
| title_fullStr | An audit of elective outpatient magnetic resonance imaging in a tertiary South African public-sector hospital |
| title_full_unstemmed | An audit of elective outpatient magnetic resonance imaging in a tertiary South African public-sector hospital |
| title_short | An audit of elective outpatient magnetic resonance imaging in a tertiary South African public-sector hospital |
| title_sort | audit of elective outpatient magnetic resonance imaging in a tertiary south african public sector hospital |
| url | https://sajr.org.za/index.php/sajr/article/view/689 |
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