Harbor:Discrepancy Review Process

Review Process

• ENTERING ED PRELIM Read on non-contrast head CT's ONLY:
  • “ED Prelim - WNL. Peterson 2320x”
  • “ED Prelim - Small SDH R parietal area. Peterson 2320x”
  • Be sure to click the button that says “Add new note” to enter your read.

• REVIEWING PRELIM DISCREPANCY LIST (QI function) Starting 10/1/18
  • Synapse: DHS Enterprise Synapse => Conferences => Critical Findings => Ed Discrepancy
    • If "Status" column says "completed", no further action needed
  • Open radiology file
  • Determine if discrepancy requires further action. Discuss with ED attending as needed
  • Place note titled "Radiology Discrepancy Review" in patient's medical record describing action taken:
    • I.e.: "CT Head from ED visit xx/xx/xx originally read as negative shows subacute cerebellar infarct. Patient needs an MRI, but transferred to outside hospital before one was done here. Called patient at xxx-xxx-xxxx, left message to call back at x3900-23202. Telegram sent. Discussed with Dr. Peterson"
    • If no further action needed - note this in discrepancy review note.
      • "Discrepancy on CT Head from xx/xx/xx noted - requires no further action. Discussed with Dr. Chappell"
  • When f/up is finished, please mark as completed: Right click on case => shortcut status => completed
  • File should be checked once per day for new cases.

Peterson/Chappell 10/1/18

Discrepancy E-mail

To: smunn@dhs.lacounty.gov; BKalantari@dhs.lacounty.gov; amlikotic@dhs.lacounty.gov; jrees@dhs.lacounty.gov; rlewis@dhs.lacounty.gov; tlittle@dhs.lacounty.gov; cavaughn@dhs.lacounty.gov

On [Date], USROC contract radiologist [Radiologist Name] submitted an interpretation for a [type of study] for patient [last name, first name], MRUN [Insert MRUN].

After our review of the study and interpretation for clinical purposes, the Department of Emergency Medicine has identified the following potential quality problem(s):  Accuracy of interpretation (may include omission of significant finding)  Delay in interpretation  Other (specify):

Following is relevant information on this case: [Insert clinical context and explanation of concern].

Therefore, we request that this study undergo a quality review as part of the Department of Radiology’s monitoring of the USROC contract.

Should you have questions on this matter, please do not hesitate to contact [Your Name] at [DHS Username]@dhs.lacounty.gov.

Thank you.

Dr. Lewis 5/2018