Journal of the American College of Radiology : JACR
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The aim of this study was to evaluate the influence of an image-sharing network established between referring hospitals and a level I trauma center on CT utilization at the trauma center. ⋯ The utilization rates of CT of different body regions have been higher for direct-admit trauma patients compared with transfer patients since 2005; however, decreasing utilization trends have been observed in recent years.
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Colorectal cancer is the third leading cause of cancer deaths in the United States. Most colorectal cancers can be prevented by detecting and removing the precursor adenomatous polyp. Individual risk factors for the development of colorectal cancer will influence the particular choice of screening tool. ⋯ The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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The aim of this study was to examine characteristics of uncompensated services rendered by radiologists to emergency department (ED) patients. ⋯ More than 28% of services rendered by radiologists to ED patients are uncompensated, corresponding to $2,584 per month per physician. That frequency and magnitude could have patient access implications.
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Bundled payment (BP) is defined as a single aggregate payment for all health care services for clinically defined episodes of care. Some results suggest that transitioning from a fee-for-service model to BP resulted in a <10% decline in spending and a 5% to 15% decrease in the utilization of services in the bundle. However, future BPs will need to account for how individual providers will be compensated for their services, and acceptance of BP as a viable health care payment model will depend on the ability of payers and providers to collaborate in a new way to address several operational and implementation challenges.
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In this review article, the authors provide a detailed series of guidelines for effectively performing root-cause analysis (RCA) and health failure mode and effect analysis (HFMEA). RCA is a retrospective approach used to ascertain the "root cause" of a problem that has already occurred, whereas HFMEA is a prospective risk assessment tool whose aim is to recognize risks to patient safety. ⋯ The principles and techniques provided here should allow reviewers to better understand the features of RCA and HFMEA and how to apply these processes appropriately. These principles include how to organize a team, identify root causes, seed out proximate causes, graphically describe the process, conduct a hazard analysis, and develop and implement potential action plans.