Quality and safety innovations in the Radiology Department during the COVID-19 pandemic: a Latin American experience

Corresponding author: Patrícia Yokoo Avenida Albert Einstein, 627/701, 4th floor, building D – Morumbi Zip code: 05652-900 – São Paulo, SP, Brazil Phone: (55 11) 2151-2452 E-mail: patyokoo@gmail.com

Conflict of interest: none.

Resource usage according to type of hospital admission	CT	X-ray	US	MRI	Interventional radiology
ICU
Usage per day	0.06	0.73	0.07	0.01	0.01
Days of use	16.1	1.3	14.6	161	80.5
Probability of use (%)	28	100	39	6	6
Stepdown
Usage per day	0.08	0.21	0	0	0
Days of use	13	4.9	0	0	0
Probability of use (%)	30	60	0	0	0
Inpatient unit
Usage per day	0.08	0.09	0.01	0.01	0
Days of use	13.0	10.6	95.7	143.5	0
Probability of use (%)	26	17	3	2	0

Type of preparedness	Procedure
Increase in volume of exams	Plan in advance to use all resources available
	Train all possible staff to be prepared to perform the most often demanded exams
	Try to predict radiology department usage and be prepared
	Use remote access to perform exams remotely
Outpatient exams	To ensure an effective triage of COVID-19 positive or suspected patients and establish droplet precautions
	Make sure the staff wear PPEs
	Comply with room cleaning procedures after the examination (aerosol and/or droplet precautions)
	Use an electronic self-service queue token
Radiologists	Train all radiologists to recognize typical COVID-19 findings
	Encourage home office
	Train on use of PPEs
Ordering physician	Provide appropriateness criteria for decision-making support: X-ray as first-line imaging modality; CT for severe patients and to estimate illness severity and help decide about hospitalization
	Design a structured report to improve understanding
	Maintain communication over the phone or by messenger applications
	Use audiovisual reports
Reporting workflow	Flag exams in the radiology information system
Reporting workflow	Incidental diagnosis of COVID-19 infection considered as a “critical finding” (must communicate result over the phone)
Hospital environment	Perform X-ray and ultrasound on the bedside
Hospital environment	Create separate paths for positive and negative COVID-19 patients to avoid hospital-acquired infection, and to provide safety to patients that cannot postpone their examinations
Other measures	Test and isolate positive healthcare providers
	Temperature measurement for all healthcare providers upon arrival at work
	Use of surgical masks by all workers
	Postponing outpatient consultation
	Enhance the use of Telemedicine
	Keep communication opened

[1] Corresponding author: Patrícia Yokoo Avenida Albert Einstein, 627/701, 4th floor, building D – Morumbi Zip code: 05652-900 – São Paulo, SP, Brazil Phone: (55 11) 2151-2452 E-mail: patyokoo@gmail.com

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Quality and safety innovations in the Radiology Department during the COVID-19 pandemic: a Latin American experience

ABSTRACT