North Texas Research Forum 2025
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Division
North Texas
Hospital
Medical City Plano
Specialty
General Surgery
Document Type
Presentation
Publication Date
2025
Keywords
diagnostic imaging, incidental findings, trauma
Disciplines
Diagnosis | Medicine and Health Sciences | Quality Improvement | Surgery
Abstract
OBJECTIVE: Incidental findings in medical imaging pose a significant challenge in healthcare due to the potential for missed follow-ups, which can lead to adverse outcomes for patients. These findings, which are unrelated to the primary purpose of the imaging study, are increasingly common due to advances in imaging technology and its widespread use. The consequences of missed follow-ups can be severe. For instance, the rate of malignancy in incidental pulmonary nodule id about 5% and follow up fails in 30-70% of cases. This means for every 120 CT chest scans ordered, 1 lung cancer is missed (McWilliams et al., 2013). One of the challenges contributing to missed follow-ups is the lack of standardized protocols for managing incidental findings. Unlike primary diagnoses, incidental findings do not always trigger immediate action plans, leading to variability in healthcare provider response. The aim of this quality improvement project is to create a standardized method for reporting incidental findings to improve patient follow up. MEATHODS: We reviewed the previous methods for communicating and documenting these findings and developed a new protocol to implement in Medical City Arlington for documentation and discharge follow up instructions. We assessed several “Prior to implementation” trauma patient charts identified patients with incidental findings. We noted how or if these findings were communicated with the patient. We created a standardized method of documenting and communicating incidental findings with MCA Trauma patients including documenting in our progress notes and creating a discharge with follow up order for a physician or IM clinic. We assessed post-study charts to determine adherence to the new standardized documenting method. RESULTS: Project is currently being implemented, and results are pending completion of the project. CONCLUSION: After communication with staff currently documenting and communicating incidental imaging findings we identified areas for improvement, including a need for a standardized method of reporting these findings. The discussions elicited information on successful strategies currently employed that could be enhanced and ideas for standardized reporting methods for the Medical City Arlington Trauma department. Implementation of this project allowed us to better educate patients about their incidentals imaging findings and help ensure patients were provided proper follow up to address these findings. We demonstrated improvement in reporting of incidental findings. With the success of this project, we hope to continue this standardized reporting method at other Medical City facilities.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Morrissey, MaKenzie; Payne, Kristen; Rittmann, Randall; Robert, Chris; Lim, Joseph; and Pigneri, Danielle, "Improving Communication and Follow Up for Incidental Findings from PanScan Imaging" (2025). North Texas Research Forum 2025. 3.
https://scholarlycommons.hcahealthcare.com/northtexas2025/3