Stroke and the ED: Rapid Triage and Intervention Are Key to Institutional Health

by Cat Vasko

Each year, nearly 800,000 people in the United States suffer strokes, making cerebrovascular disease the nation's third leading cause of death (behind heart disease and cancer). Virtually all of these patients end up in hospital emergency departments, where the ability to distinguish between ischemic strokes and the less common hemorrhagic strokes (which account for approximately 13% of cases) is crucial to determining the most effective course of treatment. Rapid triage and intervention are essential elements of a successful stroke program.

In 2007, the Stroke Center at Millard Fillmore Gates Circle Hospital (MFGCH), Buffalo, New York, transitioned from MRI to 64-detector CT for stroke triage, and in 2009, the center upgraded to a 320-detector scanner. The new protocol has enabled the program to take some patients from ambulance to scanner, saving critical time and freeing valuable emergency-department beds.

"At this point, we triage almost 100% of our stroke patients on our 320-slice scanner. We can acquire whole-brain perfusion images, which you cannot do on other systems. It's really the way to go, in terms of both the time it takes and the results."

— Erik Saluste, Imaging Manager
Millard Fillmore Gates Circle Hospital, Buffalo, New York

Radiology Billing, CSI: Managing Individual Payor Contracts

by Cheryl Proval

At NYU Langone Medical Center (NYULMC), New York, New York, even though the radiology billing department adheres to the principle of a cross-trained staff pool, it practices the explicit division of labor: Coders do nothing but code, payment posters post payments, claims processors specialize in making sure exams are coded and processed according to the specifications of each carrier, and customer-service specialists do nothing but answer questions about claims.

Engaging Physicians in Hospital Radiology Quality Initiatives

by Cat Vasko

The question of how to engage physicians in hospital quality initiatives "is one that many organizations are grappling with," according to Albert Bothe, MD, chief quality officer for Geisinger Health System, Danville, Pennsylvania. He believes that any commitment to quality must start at the top. "Quality needs to be a highly visible leadership interest," he says. "It can't just be leadership putting out memos. Leaders need to demonstrate engagement by making quality a part of their meeting agendas or doing quality rounds within the organization."

Preventing a MAC Attack: The Importance of Radiology Charge-capture Audits

by Melody W. Mulaik, MSHS, CPC, CPC-H, RCC

The advent of Medicare administrative contractors has emphasized the importance of ensuring that charge capture is consistent and accurate for the professional and technical components of care. This affects many areas, but arguably, none more greatly than outpatient diagnostic and interventional-radiology services. Hospitals and physicians encounter many challenges in trying to accomplish this task.