NYU Patient Imaging Quality and Safety  Laboratory (PIQS Lab

Horwitz, Leora

Abstract

Every year, 400 million radiology tests are performed in the United States (on average, 1.2 per person), at a cost of over $100 billion. Patients undergoing radiologic imaging or procedures are at risk for duplicative or inappropriate testing, radiation exposure, contrast reactions, procedural complications, delayed or missed diagnoses, and loss to follow up. The NYU Patient Imaging Quality and Safety Laboratory (PIQS Lab) will be a dynamic learning environment focused on improving safety and outcomes for these patients. The multidisciplinary PIQS Lab will connect experienced clinicians in the NYU Departments of Radiology, Emergency Medicine, Medicine, Orthopedics, Surgery and Urology with operations, human factors and management experts at NYU Langone Medical Center (NYULMC), the NYU Wagner School of Public Policy, and NYU Stern School of Business; and with design experts at the world-famous design firm IDEO. Together, we will comprehensively redesign our systems to improve the quality and safety of diagnostic and therapeutic radiology through three synergistic projects. In the first project, we will redesign the ambulatory radiology ordering process to minimize unnecessary or inappropriate studies. In the second project, we will redesign the inpatient interventional radiology consultation process to improve the safety of patients undergoing inpatient procedures. In the third project, we will redesign the follow-up process, from the radiology report itself to communication strategies with outside clinicians. All projects will examine radiology imaging failures through similar conceptual lenses of shared sensemaking (making sense of dynamic and ambiguous information without oversimplifying or ignoring discordant data) and sociotechnical systems (nature of the work, human-system interfaces , organization, environment, management). Supported by an Administrative/Operations core and an Informatics core. PIQS Lab faculty will take a design and engineering approach to clinical redesign, beginning with in-depth problem analysis, then preceding through design (brainstorming), development (prototyping), implementation and evaluation phases. PIQS Lab's impact will be enhanced by alignment with hospital priorities and connections to national organizations.

Public Health Relevance

The NYU Patient Imaging Quality and Safety Laboratory (PIQS Lab) will be a multidisciplinary laboratory that joins clinicians with operations, management, design and human factors experts to improve the safety and quality of radiologic imaging and procedures for outpatients and inpatients. Comprehensive redesign using a design/engineering approach can transform the patient experience and radically improve safety.