title: An electronic safety screening process during inpatient computerized physician order entry improves the efficiency of magnetic resonance imaging exams.
abstract: OBJECTIVE
  Delays between order and magnetic resonance (MR) exam often result when using the conventional paper-based MR safety screening process. The impact of an electronic MR safety screening process imbedded in a computerized physician order entry (CPOE) system was evaluated.
  
  
  METHODS
  Retrospective chart review of 4 months of inpatient MR exam orders and reports was performed before and after implementation of electronic MR safety documentation. Time from order to MR exam completion, time from MR exam completion to final radiology report, and time from first order to final report were analyzed by exam anatomy. Length of stay (LOS) and date of service within the admission were also analyzed.
  
  
  RESULTS
  We evaluated 1947 individual MR orders in 1549 patients under an institutional review board exemption and a waiver of informed consent. Implementation of the electronic safety screening process resulted in a significant decrease of 1.1 hours (95% confidence interval 1.0-1.3 hours) in the mean time between first order to final report and a nonsignificant decrease of 0.8 hour in the median time from first order to exam end. There was a 1-day reduction (P = .697) in the time from admission to the MR exam compared to the paper process. No significant change in LOS was found except in neurological intensive care patients imaged within the first 24 hours of their admission, where a mean 0.9-day decrease was found.
  
  
  CONCLUSIONS
  Benefits of an electronic process for MR safety screening include enabling inpatients to have decreased time to MR exams, thus enabling earlier diagnosis and treatment and reduced LOS.
authors.affiliation: Imaging Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, USA. Electronic address: schneie1@ccf.org.
authors.forename: Erika
authors.initials: E
authors.lastname: Schneider
authors.forename: Paul
authors.initials: P
authors.lastname: Ruggieri
authors.forename: Lauren
authors.initials: L
authors.lastname: Fromwiller
authors.forename: Reginald
authors.initials: R
authors.lastname: Underwood
authors.forename: Brooke
authors.initials: B
authors.lastname: Gurland
authors.forename: Cynthia
authors.initials: C
authors.lastname: Yurkschatt
authors.forename: Kevin
authors.initials: K
authors.lastname: Kubiak
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Obuchowski
mesh_terms: D003287:Contrast Media / Q000009:adverse effects; D020000:Decision Support Systems, Clinical / Q000458:organization & administration / Q000706:statistics & numerical data; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008279:Magnetic Resonance Imaging / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data*; D050316:Medical Order Entry Systems / Q000458:organization & administration / Q000706:statistics & numerical data*; D061214:Patient Safety / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D003287:Contrast Media
keywords: CPOE; Electronic health record; Magnetic Resonance Imaging; order; patient safety