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Radiology and Imaging Care

Radiological Quality and Safety: CT Scanning

Computed Tomography (CT) is a diagnostic tool that combines x-rays with state of the art computer technology to produce "cross-sectional" images of the body. These images show the venous system, organs, bones, and tissue in great detail. Most procedures using CT are quick, taking only 15 - 30 minutes to complete.

The Department of Radiology CT Division at Beth Israel Deaconess Medical Center uses the latest imaging techniques and equipment to produce precise, quality diagnostic images vital for referring physicians in planning the medical treatment of their patients. Dedicated to giving the best possible patient care, our highly trained faculty and staff are active in research that ensures our scanning techniques are appropriate, safe, and effective.

Beth Israel Deaconess Medical Center Department of Radiology has been awarded a three-year term of accreditation in Computed Tomography by the American College of Radiology.

Patient Safety:  Use of Medical Imaging

PATIENT SAFETY: USE OF MEDICAL IMAGING BIDMC PERFORMANCE
JAN 2009 - DEC 2009
NATIONAL AVG JAN 2009 - DEC 2009
"Combination" (Outpatient CT scans of the chest
(The range for this measure is 0 to 1. A number very close to 1 may mean that too many patients are being given a double scan when a single scan is all they need.)
lower score is better.
.003 .052
"Combination" (with and without contrast) Outpatient CT scans of the abdomen (The range for this measure is 0 to 1. A number very close to 1 may mean that too many patients are being given a double scan when a single scan is all they need.)A  lower score is better. .202 .176

Data Source:  The source of the comparison for these measures is Hospital Compare , Centers for Medicare & Medicaid Services, January , 2012.

Radiological Quality and Safety

Our commitment to providing the highest quality of medical imaging services to our patients is evidenced by our successful accreditation by the American College of Radiology (ACR). This means that we have achieved and been recognized for our high practice standards following a peer-reviewed evaluation of our practice. Image quality and procedure evaluations were conducted by a panel of expert board certified radiologists and medial physicists.

What are we measuring?

The Use of Medical Imaging data (above) measures the rate of combination (or multi-phasic) Computed Tomography (CT) scans of the abdomen and chest performed on patients at BIDMC. This is a CT scan that is performed twice on a patient during the same setting, typically with and without iodinated contrast.

Combination scans are appropriate when it is important to view abdominal structures such as the liver before and after the administration of contrast. Thus, in daily practice, combination scans are most commonly indicated when imaging the abdominal organs. However, it is not necessary to perform a combination CT scan of the chest except when investigating acute diseases of the vascular structures such as the aorta, the major arterial vessel in the chest. In this setting, a combination scan may provide complementary information crucial for diagnosis and optimal patient care.

Note: Our performance rates are calculated and published by the Center for Medicare & Medicaid (CMS). The performance presented here represents the most recent data available.

Why is this important?

Inappropriately ordered combination CT scans have the potential to unnecessarily expose patients to extra radiation. The rate of combination scans is considered by CMS as an indicator of how well a hospital is following recommended guidelines for use of CT scans and reducing unnecessary patient exposure to radiation. Learn More about BIDMC's Programs to Reduce Radiation Exposure, and about Medical Imaging Safety.  

What is our performance telling us?

The charts below shows how BIDMC's performance compares to the National Performance average for the rate of combination or multi-phasic scans of the abdomen and chest for the most recent available performance period. Look for big differences in the rates in order to be sure that the difference is meaningful. Small differences may not reflect real differences in performance (i.e., they may not be statistically significant).


Data Source:  The source of the comparison for these measures is Hospital Compare, Centers for Medicare & Medicaid Services, January , 2012.

BIDMC's rate of combination CT Scans of the Chest during the calendar year 2009 is .003. This reflects 7 combination scans out of 2452 CT scans of the chest. For comparison, the National Average rate of combination scans of the chest is .052. BIDMC's performance is better than the national average.



Data Source:  The source of the comparison for these measures is Hospital Compare, Centers for Medicare & Medicaid Services, January , 2012.

BIDMC's rate of combination CT scans of the Abdomen during the calendar year 2009 is .202. This reflects 420 combination scans out of 2080 CT scans of the abdomen. For comparison, the National Average rate of combination scans of the abdomen is .176. BIDMC's performance is technically Higher than (worse than) the national average. 

While the national average performance is lower, it reflects CT scaning practices across a broad variety of health care settings.  At BIDMC, as a academic teaching hospital, we provide care for a very select patient population where more complex examinations are often necessary.  Additionally, differences in data collection and billing may also contribute to these rates, as not all institutions bill for both scans as a "combination" but rather as two single scans which may not have been tracked by the CMS.

What are we doing to improve our performance?

We have instituted our Image Lightly™ program to ensure that safe and high quality imaging services for our patients is our priority.

  • We pledge that our patients will receive the optimal diagnostic CT study while receiving less radiation as we practice the ALARA principles: As Low As Reasonable Achievable; and

  • We pledge to image lightly while providing high quality diagnostic CT imaging studies to enhance your care at BIDMC.

CT scanning is a very valuable and useful diagnostic tool. Our Image Lightly™ program ensures that all patients receive As Low As Reasonable Achievable (ALARA) radiation exposure by:

  • Ensuring that all imaging equipment that is up to date, and monitored closely for compliance with our quality assurance program
  • Ensuring that our Imaging technologists that are highly trained and follow the best evidenced based protocols
  • Providing customized imaging, tailored to the specific characteristics of each patient by
    • calculating the dosages appropriate for each patient at the time of scanning
    • pin-pointing exact areas to be scanned, and placing patients properly, and
    • moving patients as quickly as possible through the device.
  • Avoiding duplicative scanning, and working with our patients to ensure that scans performed outside BIDMC are made available to us to avoid an unnecessary scan.

Learn more about Image Lightly™, and view useful and informative videos on imaging. For more information visit ACR - American College of Radiologists, the professional organization that accredits BIDMC's CT program.

Last update March 20, 2012

Contact Information

Silverman Institute for Health Care Quality and Safety
Beth Israel Deaconess Medical Center
330 Brookline Ave
Boston, MA 02215
617-667-1325