Medical Imaging

Frequently Asked Questions

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Frequently Asked Questions

Essential imaging aims to spread the BC Guidelines for Appropriate Imaging which provide practice guidelines for care providers in five common medical imaging areas in Primary and Emergency Care. It also provides key messages and advice to inform person- and family-centred decision making.

Key Recommendations:

  • It is not recommended to order imaging for low back pain unless red flags are present;
  • It is not recommended to order CT head scans in adults and children who have suffered minor head injuries unless positive for a head injury clinical decision rule;
  • It is not recommended to order imaging for uncomplicated headache unless red flags are present;
  • It is not recommended to order MRIs of hip or knee joints in patients with co-existent pain and osteoarthritis unless red flags are present; and
  • It is not recommended to order chest CT for suspected pulmonary embolism in low-risk patients with a normal D-dimer result.

Evidence indicates that between 10% and 20% of medical imaging studies are unnecessary or inappropriate.[1]  The Emergency Department (ED) and Primary Care settings provide a unique opportunity to connect with people who have questions or concerns on when to image and when to not image.

Your team is likely already experiencing instances of inappropriate and appropriate medical imaging daily and this initiative will support you to provide evidence-based, quality care.

Applying best practice for people worried about whether to image or not to image improves patient care and has the potential to reduce radiation and downstream testing, reduce variation in practitioner ordering, enable improved access for indicated imaging tests and in the case of ED diagnostics, reduce ED congestion due to testing time.

This initiative supports care providers to network and work together in new ways to expand team-based care, brings services together and improves coordination of care, and increases access for patients and care providers to appropriate services. This initiative will focus on appropriate management and enriching patient relationships.

There is incredible work already happening across the province that is unique and adapted to local contexts and communities. This initiative model is an effective and efficient way to leverage that work by offering a platform for teams to connect and learn from each other as well as a faculty of experts to support them.

 

Participating teams will be provided the following resources and supports:

  • A Getting Started Kit to help teams develop a better understanding of appropriate medical imaging and plan their quality improvement;
  • Resources to support site-specific campaigns to target information for care providers and patients;
  • Website access to view and download all materials and find appropriateness-related resources;
  • A network of 21 other teams across the province for inspiration and support;
  • A series of interactive webinars grounded in evidence and led by expert faculty;
  • Virtual coaching and support;
  • A certificate of completion; and
  • A copy of the final report for the initiative.

Your team will benefit from focused support, the opportunity to collaborate with, and learn from, other teams from across the province, and quality improvement training that can be applied to all areas of care you provide.

An action series is a set of monthly virtual webinars that support teams to expand on what they already know and develop and strengthen new skills and knowledge in order to hardwire best practices into everyday work. Teams from different emergency departments, primary care and specialist settings will work on the same problem at the same time, focusing on their specific local needs.

Through virtual learning, teams will have the opportunity to share effective change strategies, experience quality improvement coaching, learn about clinical best practices, access online resources and templates and be supported for data collection and analysis, all while leveraging organization and social networks as needed for success.

Within the action series, teams will have access to a set of robust resources to support site-specific campaigns to target information for care providers and patients. Specific campaign change ideas are included. The campaign will be supported by the development of information resources, posters and information sheets for patients and care providers.

A measurement plan will be included in the Getting Started Kit with suggested measures for teams to track their improvement efforts and impacts.

Sites participating in Essential Imaging will form interdisciplinary teams. These teams will identify goals and strategies specific to increasing appropriate medical imaging in their local ED, primary care or specialist setting, including developing connections to expand team-based supports for practitioners and patients.

Teams will support practice change, measure and evaluate their success and share their experience with others across the province. Teams will be expected to provide regular reporting as a condition of participating, but measurements will be kept as simple as possible to avoid extra burden.

For evaluation purposes, teams will also be asked to share information and data following the completion of the initiative in January 2021.

Team members should plan to:

  • Engage in team meetings and project work at their site;
  • Connect with other teams and exchange ideas;
  • Participate in a one-hour webinar every four to six weeks (note that all webinars will be recorded to facilitate easy referencing and various shift schedules).

Look for our Call to Action posters in your local department to sign up! Reach out to your local clinical leaders to see if they are coordinating a team or contact your clinical department leader to see if your site has been identified for the initiative. If you are not sure who your local team lead is, please contact us at imaging@bcpsqc.ca

A clinical lead that is connected to a health authority has been tasked with identifying sites with the most need and interest in participating. The focus is on a distribution of sites linked to a health authority and a mix of rural and urban sites of various sizes.

If your site is not currently involved in the initiative, you are still welcome to contact us at imaging@bcpsqc.ca and sign up for our mailing list, where you’ll receive updates and access to all our resources and webinars once they have been posted to the website.

Anyone who is interested in improving medical imaging appropriateness! This may include family physicians, nurse practitioners, emergency medicine practitioners, specialists, radiologists, technologists and clerical support staff, patient partners, physiotherapists and others.

Your team should aim to recruit four to seven people from different disciplines, including clinicians who work in partnership with a health authority, primary care and divisions of family practice. You may consider augmenting your team from time to time with ad-hoc members as needed – the makeup of your team is up to you!

Yes, you can still participate! Webinars will be recorded and made available to view. Coaching calls will be scheduled to work with the local team to allow as many team members to attend as possible. The learning and testing of change ideas can happen on a flexible schedule that works for your team.

Webinars will be scheduled and delivered using WebEx, which can be accessed at https://bcpsqc.webex.com/  on the day of the event. This technology has both video conferencing and call-in options. Webinars will be recorded and posted online for anyone not able to attend in person.

Specific information on the webinar and login instructions will be shared well in advance of the event.

There is no charge to participate in the initiative. The improvement work involved in this initiative will be supported by your leader and embedded into your everyday workload.

Individual team members will contribute the time required to participate in the initiative including:

  • Engaging in team meetings and communication
  • Participating in online webinars (or recordings)
  • Executing change ideas and tests of change!

All the content and learning generated from this initiative will be accessible online as the initiative progresses. Watch for updates with the web address soon!

Please contact the Essential Imaging project team at imaging@bcpsqc.ca


Key Contact

Sarah Carriere
Leader, Health System Improvement
scarriere@bcpsqc.ca
604.668.8215