Medical Staff Pulse is
a Publication of the Chief of Staff
New Inpatient Imaging Guidelines

Evidence-Based Guidelines Are Offered as Suggestions, Not Rules

Barry D. Pressman, M.D. / Glenn Braunstein, M.D. / Paul A. Silka, M.D.
Chair, Dept. of Imaging / Chair, Dept. of Medicine / Chief of Staff

To help improve and expedite the appropriate use of imaging for Cedars-Sinai inpatients, the Department of Imaging and the Department of Medicine, with the help of many medical staff members, have developed evidence-based guidelines for medical staff use with Imaging inpatients for a number of clinical issues. Click here to view a PDF copy of the guidelines.

These guidelines have been reviewed and approved by the Department of Medicine PIC, presented to the Department of Surgery PIC, and were recently endorsed by the Medical Executive Committee.

These guidelines are being offered to you as suggestions, not rules, for consideration in your daily practice. They were developed with the goal of assuring that our patients receive the most appropriate and efficient care while maintaining the highest quality. "Appropriate care" refers to both the necessity of a study and the necessity of performing that study during the inpatient stay.

We strongly request that you spend a few minutes reviewing these guidelines, and then let us know your thoughts as you incorporate them into your patterns of ordering inpatient imaging studies. We are interested in your comments so that we can continue to refine these guidelines for the benefit of the medical staff and our patients.

In the near future, a screening nurse will be reviewing the consultation requests for MR and CT of the brain and spine to see if the patient falls under these guidelines. If not, the ordering physician will be contacted to discuss the indications for requesting the examination. Since these are guidelines, and not rules, such examinations will not be unduly delayed, and certainly will not be denied. Rather, we hope this type of communication will serve as a positive opportunity for education about the guidelines and also help us refine them on a continual basis.

One guideline that we ask you to especially note concerns the inadvisability of ordering portable chest x-rays prospectively on a daily basis. Instead, they should be ordered each day as needed. Your immediate cooperation in this regard would be greatly appreciated.

We sincerely hope you will find these guidelines to be of assistance in the care of your patients. Your thoughts and suggestions are welcome.