TRIO059 - Radiology Administered Protocol for MRI in Patients with Cochlear Implants without Magnet Removal to Enhance Workflow Efficiency and Patient Safety
Saturday, April 30, 2022
10:25 AM – 10:30 AM CT
Location: Landmark B
Robert E. Watson MD PhD; Britany J. Wiste BS; John I. Lane MD; Heidi A. Edmonson PhD; Matthew L. Carlson MD
Educational Objective: At the conclusion of this presentation, the participants should be able to describe the development, implementation, and validation of a radiology administered protocol to obtain MRI in patients with cochlear implants, without magnet removal.
Objectives: To describe the development, implementation, and validation of a radiology administered protocol to obtain MRI in patients with cochlear implants, without magnet removal.
Study Design: Retrospective review and description of novel care pathway.
Methods: At many centers, an otolaryngology provider is required to assist with headwrap placement and post-scan examination, which results in workflow inefficiency for the radiology team and strain on otolaryngology service bandwidth. A radiology administered protocol was designed based on careful input from the neuroradiology safety group and neurotology. Radiology technologist training modules, consent instructions, patient educational material, clinical audits, and other safeguards were implemented. The primary outcomes measured were magnet dislodgement during MRI, and operational efficiency under the new protocol.
Results: Since implementation in June 2018, 247 patients have completed one or more MRI studies using the radiology administered protocol. Regular clinical audit shows no reduction in patient safety when compared to a historical institutional cohort who were "wrapped" by an otolaryngology provider [12 (5%) patients experienced magnet tilt or flip]. The protocol has reduced pre- and post-scan delays and eased clinical demands for otolaryngology providers.
Conclusions: We present the successful implementation of a standardized radiology administered protocol to streamline care and enhance safety for cochlear implant recipients who require MRI. Resources developed, including a process map, radiology training modules, consent instructions, patient educational materials, clinical audit, and other procedural safety measures are provided so that interested groups may consider adopting similar measures according to need.