Completed Projects

The Decision Analysis Matrix: A Systematic Method to Improve Collaborative Decision-Making
DiRoberto, C., Lehto, C., Baccei, SJ.
9/2016
UMass Memorial Medical Center Department of Radiology

http://www.jacr.org/article/S1546-1440(16)30003-5/abstract
This project detailed the implementation in our radiology dept. of the Decision Analysis Matrix, which is a quantitative tool used to improve collaboration and facilitate group decision making on large-scale issues. It solves the problem of inefficient and time consuming decision making when large numbers of stake holders are involved

 

Reducing Radiation Exposure without Compromising Image Quality for Lumbar Spine CTs
Chen, B., DiRoberto, C., Baccei, SJ.
9/2016
UMass Memorial Medical Center Department of Radiology

http://www.jacr.org/article/S1546-1440(15)01073-X/abstract
This project started by detailing the reasons behind the above-average dosage of radiation at our institution for lumbar spine CTs.  It shows how a cohort of larger patients skewing data and the need to implement a max dosage, specifically in these cases. Image quality was not disrupted after the implementation of countermeasure as confirmed by a survey of radiologists

 

How to Effectively Implement a Peer Review Process for Interventional Radiology Procedures
Caruso, MJ., DiRoberto, C., Baccei, SJ.
7/2016
UMass Memorial Medical Center Department of Radiology

http://www.jacr.org/article/S1546-1440(16)30222-8/abstract

Peer Review was not available for Radiology Interventional Procedures.  This project details the method of our implementation of an IR peer review process and its challenges and successes. 

 

Radiology Report Optimization Initiative
Baccei, SJ.; Cerniglia C., Coughlin, D., Rosen, Max
9/2015 – 5/2016
UMass Memorial Medical Center Department of Radiology

Radiology reports contained duplicative information when viewed on downstream applications including indication and technique.  We eliminated the “dictated” indication and technique sections from radiologist’s reports of radiographs.  This resulted in improved satisfaction from ordering clinicians, reports that were more concise, and improved efficiency from radiologists.

 

Improving the Transcription of Patient Information from Image Requisitions to the Radiology Information System
DiRoberto, C., Lehto, C., Baccei, SJ.
5/2016
UMass Memorial Medical Center Department of Radiology

http://www.jacr.org/article/S1546-1440(16)30174-0/abstract
This project detailed the extent of errors in our process of transcribing information from image requisition to the radiology information system. In addition to revealing this data, we also implemented affective countermeasures, including a checklist and re-education for tech staff, and as a result drastically improved the efficiency and accuracy of communication.

 

IRB Radiology Template Initiative
Baccei, SJ.; DiRoberto, C.; Johnson, K; Saliba, S
8/2015 - 10/2015
UMass Memorial Medical Center Department of Radiology and the IRB

http://www.umassmed.edu/radiology/research/radiology-irb-sutdy-plan-template/
Through a collaborative effort between radiology and the IRB a streamlined template for retrospective radiology chart review studies was developed. Previously, these types of studies (that in most instances ultimately were determined exempt from IRB review) required a full, lengthy study plan. By using the new streamlined template, radiology researchers will be able to expedite the study plan portion of their IRB submission. This exciting initiative is expected to promote a significantly higher rate of research publications in our department and is now accessible to all radiology staff on the department website.

 

Improving Communication of Actionable Findings in Radiology Imaging Studies and Procedures Using an EMR-Independent System.
Baccei, SJ. DiRoberto, C. Green, J., Howe, J., Rosen, MP
1/2015-1/2016
UMass Memorial Medical Center Department of Radiology

http://www.umassmed.edu/radiology/about-us/radiology-news2015/
We detailed a method for improving the communication of actionable findings between radiologists and referring providers at our institution, which lacks a fully integrated electronic health record.

 

Duplicate Medical Record Reduction and Merging Initiative for MRI
Baccei, SJ., Easton, A, Dundamadappa, S
7/2015 – 7/2016
UMass Memorial Medical Center Department of Radiology and Shields JV

Worked with Shields (MRI) lead technologists to develop and implement a strategy to reduce duplicate MRN for MRI patients and merging MRI patients with existing studies on PACS. The group developed a PeerVue module to monitor unmerged MRNs for MRI patients. Unmerged cases were reduced. 

 

Improving Radiographic Quality at a Busy Outpatient Imaging Center
Baccei, SJ., Cerniglia C.
5/2015
UMass Memorial Medical Center Department of Radiology

http://www.jacr.org/article/S1546-1440(14)00855-2/abstract

Radiographic image quality was poor and inconsistent for musculoskeletal studies performed at the Ambulatory Care Center location. A method for recording image quality was developed and countermeasures instituted. Radiographic image quality dramatically improved. 

 

Radiology Ordering Guidelines for Pregnant Patients with Suspected Pulmonary Embolus
Baccei, SJ., Manning, M, Schmidlin, E, Licho, R
4/15 – 6/15
UMass Memorial Medical Center Department of Radiology and Department of Ob/GYN

A formalized approach/guideline for the ordering of appropriate imaging studies for pregnant patients with suspected pulmonary embolus did not exist.  This created confusion, frustration, and imaging delays for clinicians in the radiology and ob/gyn departments ultimately affecting patients.  A collaborative committee was established between the departments of radiology and Ob/GYN to review the literature and establish clinical guidelines for appropriate ordering of imaging studies for pregnant patients with suspected PE.  Guidelines were developed which improved the ordering of appropriate exams. 

 

Development and Implementation of the Digital Block for Radiology Imaging Studies
Baccei, SJ., Egan, L, General Electric Technical Representatives
3/14 - 5/14
UMass Memorial Medical Center Department of Radiology and Information Services

Radiology images could be added to radiology studies in the finalized status.  This loophole created patient safety issues because these “added” images often were not reported to the radiologist and therefore went unread.  A collaborative effort resulted in the identification of the root cause for this problem and development of a new workflow to eliminate this loophole.  Radiology images can no longer be added to imaging studies in the finalized status dramatically improving patient safety.

 

Exploratory Committee for Assessing the Feasibility of Transitioning Breast Imaging from a Paper Workflow to an Electronic Workflow
Baccei, SJ., Brennan D., Breast imaging leads across the institution
6/2015
UMass Memorial Medical Center Department of Radiology

Breast Imaging Services throughout the UMass system relies primarily on a paper workflow.  A paper workflow is inefficient and subject to a variety of problems including lost documentation and failure to implement follow up recommendations.  A workflow map was built by the team to evaluate the feasibility of transitioning breast imaging workflow to an all-electronic model.  Unfortunately, inherent weakness and limitations of IT infrastructure prevented the implementation of an all-electronic breast imaging workflow at the time of this evaluation. 

 

UMass Memorial Medical Center Radiology Department, Marlborough Hospital Radiology Department, and Clinton Hospital Radiology Department Quality Committee Integration
Baccei, SJ., Brennan D., Riggieri P
3/2015
UMass Memorial Medical Center Department of Radiology 

UMass Memorial Medical Center Department of Radiology acquiring the contract to provide radiology services for Marlborough and Clinton Hospitals in March 2015. Marlborough and Clinton Hospital Radiology needed to be integrated onto the radiologist department quality committee at UMass including receiving reports from the PeerVue system and participating in quality committee meetings and activities. This was accomplished through collaborative work between the radiology quality committee and management at Marlborough and Clinton Hospital Radiology.  Marlborough and Clinton Hospitals Radiology Departments remain active members on the quality committee. 

 

Musculoskeletal Radiology Procedure Efficiency and Optimization initiative at Marlborough Hospital
Cerniglia C., Baccei, SJ., Brennan D., Riggieri P
3/2015 – 6/2015
UMass Memorial Medical Center Department of Radiology 

Musculoskeletal Procedures at Marlborough Hospital were being performed at variable times throughout the day and week.  This created inefficiencies and created unnecessary variabilities contributing to increased patient wait times and radiologist staffing issues. Musculoskeletal procedure scheduling slots were created for mornings on 4 days a week. The C-Arm fluoroscopy unit was also obtained for Musculoskeletal Procedures. These actions improved patient flow, patient wait times, and greatly simplified the radiologist schedule while improving efficiency.

 

Quality and Patient Safety Section Development; Radiology Webpage
Baccei, SJ., Stephenson, Gabrielle
1/2015
UMass Memorial Medical Center Department of Radiology 

http://www.umassmed.edu/radiology/quality/

The Radiology webpage lacked a Quality and Patient Safety Section. Worked collaboratively with the newsletter/webpage editor to develop the quality and patient safety section of the webpage and provided all the source material including projects. The quality section was successfully implemented and remains a core section of the webpage.

 

Accuracy of Preliminary Resident Reports on CT Pulmonary Angiogram
Shin H, Baccei, SJ.
2014-2015
UMass Memorial Medical Center Department of Radiology 

Anecdotal evidence suggested that radiology residents interpreting CT Pulmonary Angiogram studies had a high “miss” rate.  A proposal for attending only interpretations of these studies, even after normal work hours, created the need for a formalized evaluation of the accuracy of radiology resident readings of CT Pulmonary Angiogram studies during “on-call” hours.  This evaluation concluded that radiology residents were within the standard of care for accuracy of CT Pulmonary Angiogram study interpretation.  This allowed for the continued (preliminary) interpretation of these studies by radiology residents during the “on-call” hours saving the radiology department resource allocation for 24hr/7day attending radiologist interpretation of these exams.

 

MRI Hanging Protocol Improvement and Standardization Initiative for Musculoskeletal Images
Baccei, SJ., Sa M, Easton A
2014-2015
UMass Memorial Medical Center Department of Radiology 

Image display for MRI studies on the UMass PACS system was highly variable and hanging protocols did not uniformly work.  The root cause of this problem was non-standardized naming convention of MRI sequences between scanners.  A team was established and collaborative efforts resulted in standardized naming convention on shoulder and knee MRI studies across all MRI scanners in the UMass/JV system enabling the functionality of hanging protocols for imaging view on PACS.  This served to improve radiologist efficiency and diagnostic accuracy for these studies.

 

UMass Memorial Medical Center and Shields Joint Venture Quality Committee Integration
Baccei, SJ., Sa M, Easton A
2014-2015
UMass Memorial Medical Center Department of Radiology 

A new Joint Venture was created between the UMass Memorial Medical Center Department of Radiology and Shields MRI for the interpretation of MRI exams performed by Shields and read by UMass Memorial Medical Center Radiologists.  The JV needed to be integrated onto the radiologist department quality committee including receiving reports from the PeerVue system and participating in quality committee meetings and activities.  This was accomplished through collaborative work between the radiology quality committee and lead technologists for Shields.  The JV remains an active member on the quality committee.

 

Patient Satisfaction and Complication Assessment Initiative for Interventional Radiology Procedures
Baccei, SJ., Alencar H
2014-2015
UMass Memorial Medical Center Department of Radiology

Individual case evidence suggested an unsatisfactory level of patient satisfaction, including dissatisfaction with pain control and anesthesia, during interventional radiology procedures.  A team was assembled and post interventional radiology procedure patient survey was developed to evaluate patient satisfaction and complication rate.  Through this initiative, improvements in pain assessment and control including anesthesia level were implemented in interventional radiology division.  Overall patient satisfaction with interventional radiology procedures was found to be at an acceptable level.

 

Document Viewer in PACS for MRI Imaging Studies
Baccei, SJ., Bartholomew C
6/2014-9/2014
UMass Memorial Medical Center Department of Radiology and Shields MRI

Patient information and history on scanned documents obtained at the time of MRI imaging were not viewable to the interpreting radiologist on PACS. This created the potential for incorrect and/or incomplete diagnosis of imaging findings. A collaborative effort resulted in the creation of a “plug-in” software program enabling viewing of the relevant documents in PACS at the point of radiologist image interpretation. This initiative improved patient safety, diagnostic accuracy on MRI studies, and radiologist efficiency.

 

PeerVue Program Implementation
Baccei, SJ., Smith, D
1/2014 – 10/2014
UMass Memorial Medical Center Department of Radiology and Information Services

The department of radiology had no formalized approach to monitoring image quality, communicating critical results, peer review, or billing and coding queries.  The design and implementation of the PeerVue software was successfully completed. As a result all of these processes are standardized in a signal software platform accessible to the radiologist at the point of image interpretation.

 

Quality and Patient Safety Infrastructure Development
Rosen, M, Baccei, SJ.
1/2014
UMass Memorial Medical Center Department of Radiology 

The department of radiology lacked a dedicated infrastructure and organization for quality and patient safety.  A quality and patient safety committee was created with quality representatives from all clinical and technical sections with quarterly meetings.  A formalized peer review process was created.