Evaluation of the quality of radiology requisitions for intensive care unit patients.
OBJECTIVE
The study aim is to evaluate the quality of radiology requisitions for plain film radiographs on intensive care unit (ICU) patients.


METHODS
Radiology requisitions for 58 patients in ICU units at our children's hospital and the corresponding original orders for the study, written in patients' charts, were obtained. We reviewed each of the resident's written chart orders for completeness and then directly compared the information on the radiology requisition with the actual order written in the patient's chart by the ward resident physician.


RESULTS
In 10% of cases, no "written order" was found in the patient's medical record for the imaging study. Clinical indications for the study were provided by the resident in only 71% (41/58) of cases. The resident's name was missing in the chart in eight of 58 cases (14%). The resident's name was provided in 50 cases, but was legible in only 28 of 50 cases (56%). In 84% of cases, the resident failed to provide his or her pager number. For one patient, the incorrect study was ordered. In only 73% (30/41) of cases did the ward clerk exactly copy the clinical indication that was handwritten in the chart by the resident. In 21% of cases, no resident's name was provided as the ordering resident on the radiology requisition. Inadequate or incomplete clinical information was provided in 24% of cases.


CONCLUSIONS
Our study identifies a large number of problems in the quality of our radiology requisitions. Improving the process has been approved by our hospital as a major quality improvement project for this year.
Cohen
Mervyn D
MD
Department of Radiology, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, IN 46202, USA. mecohen@iupui.edu
Curtin
Shelly
S
Lee
Robert
R
D002982:Clinical Clerkship; D005568:Forms and Records Control; D006801:Humans; D007196:Indiana; D015278:Intensive Care Units, Pediatric / Q000592:standards*; D007396:Internship and Residency; D050316:Medical Order Entry Systems; D016347:Medical Records Systems, Computerized; D011785:Quality Assurance, Health Care; D011872:Radiology Department, Hospital; D011873:Radiology Information Systems / Q000706:statistics & numerical data*