PURPOSE: To assess how recent implementation of the Fleischner Society of Thoracic Radiology pulmonary nodule surveillance guidelines have impacted workload, man-hours, cost-effectiveness and patient radiation dose at Madigan Army Medical Center.
METHODS: Total number of Chest CT scans and number of follow-up scans specific for pulmonary nodule evaluation were retrospectively totaled for one year prior and one year after implementation of the new pulmonary nodule surveillance guidelines. This data was then used to quantitate the effects that the guidelines had on workload, man-hours, cost-effectiveness and patient radiation dose. CT Pulmonary angiograms, CT Oncology exams, and other cross-sectional imaging studies acquired for evaluation of patients with known malignancy were excluded.
RESULTS: Number of Chest CT scans obtained for pulmonary nodule surveillance the year prior to implementation of the Fleischner society guidelines totaled 1091/2377 (48%). This number substantially decreased the year following to 640/2074 (31%), which corresponds to an overall reduction in workload of 15%. Using this data, we also found that the new guidelines saved a total of 90 staff and 113 technologist man-hours. In addition, we found that there was a total cost reduction of approximately $135,300 and decreased patient radiation dose of 1579 mGy.
CONCLUSION: Recent implementation of the Fleischner Society guidelines for pulmonary nodule surveillance has made a considerable short-term contribution to decreasing our departmental work-load and man-hours, improving cost-effectiveness and reducing patient radiation dose.
CLINICAL IMPLICATIONS: Continued monitoring is needed to assess if the current downward trend in man-hours, cost and radiation dose will persist, and to assess how long-term patient care may be affected.
DISCLOSURE: William Lewis, No Financial Disclosure Information; No Product/Research Disclosure Information