Vanderbilt Ingram Cancer Center

 

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Vanderbilt University Medical Center, Vanderbilt Ingram Cancer Center
Nashville, Tennessee

Oncology Capture of ED Patients with Incidental Radiologic Findings

Nicholas Garland, MS, Administrative Fellow
Katharine Klar, RN, BSN, Assistant Nurse Manager

Increased use of CT scans in emergency departments leads to higher rates of incidental radiologic findings, including adrenal masses and pulmonary lung nodules. In this “pull” model for follow-up care, ED providers use the EHR to prompt oncology nurse navigators and case managers to contact patients with incidental findings. Prompt follow-up allows for earlier diagnosis and treatment—improving care and the patient experience. From a business perspective, the cancer program realized financial gains through additional visits, procedures, surgeries, radiology scans, and/or lab.

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Addressing ED Incidental Imaging Findings Through Navigation

Innovator-2021-Seal-singular-80x80When a patient presents for care in an emergency department (ED), unexpected issues unrelated to the patient’s chief complaint may be flagged. For example, when patients receive MRI imaging or CT scans, ED staff may identify incidental findings (such as adrenal masses or pulmonary nodules) that require follow-up. But leaving it up to patients to navigate their subsequent care appropriately comes with the risk that such follow-up may never occur.
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v37n4-oncology-capture-of-ed-patients-with-incidental-radiologic-findings-220x296.pngOncology Capture of ED Patients with Incidental Radiologic Findings

Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center in Nashville, Tenn., recognized that their current push model of care and referral processes for ED patients with incidental findings had significant opportunities for improvement. With the opportunity to redesign our processes, we assembled a project team to evaluate the current and ideal state for assisting ED patients with incidental findings. This team included VanderbiltIngram Cancer Center’s associate nursing officer, chief surgical officer, nurse navigators, a project manager, and a business analyst, as well as ED stakeholders, such as the executive medical director, case managers, and a social worker.
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News & Media

Team Receives Association of Community Cancer Centers Innovator Award
VUMC Reporter, Nov 18, 2021

Being Proactive About Incidental Findings Improves Patient Care
ObR Oncology, Nov 12, 2021