PROPOSAL TITLE:

Reducing Unnecessary Radiation Exposure from Chest X-rays in Lung Transplant patients.

PROJECT LEADS:

David Gordon, DNP, ALD APP

Jasleen Kukreja, MD, Program and Surgical Director, Lung Transplantation

EXECUTIVE SPONSOR: Carolyn Light, MPA, Executive Director, Transplant Services

TEAM PROJECT MEMBERS:

It is currently challenging to determine which medicine patients may be eligible for admission or transfer to non-Parnassus sites of care (e.g. Mount Zion, Saint Mary’s Medical Center (SMMC)). Admitting physicians must manually check clinical and social inclusion criteria and bed availability for each site, an inefficient process that may lead to suboptimal use of available non-Parnassus beds. The process of identifying medicine patients appropriate for lateral transfers is similarly tedious and because it is dependent on physician referral, it fails to capture a large proportion of potentially eligible patients. We propose creating 1) an EHR-based, admission clinical decision support tool to guide admitting physicians in determining the optimal site of admission for medicine patients, and 2) a workbench report to identify admitted patients appropriate for lateral transfer to a non-Parnassus site of care. The combination of these tools will reduce the time needed to identify and transfer appropriate patients, increasing use of unfilled, staffed beds at non-Parnassus sites. This will increase tertiary/quaternary bed availability at Parnassus, creating an estimated $1.79M/year in contribution margin by better matching patient acuity to the appropriate site of care.  This will also improve patient and provider experience of the admission and transfer process.