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Article ; Online: Liberating Structures in Strategic Planning: Methods to Foster Engagement.

Zafar, Hanna M / Rawson, James V

2024 Volume 31, Issue 2, Page(s) 438–445

Abstract: This paper describes the innovative approach of using liberating structures to the development of the AUR 2023 strategic plan, and lessons learned in their application. The 2023 strategic plan built on the results and approach of the prior 2015 plan. ... ...

Abstract	This paper describes the innovative approach of using liberating structures to the development of the AUR 2023 strategic plan, and lessons learned in their application. The 2023 strategic plan built on the results and approach of the prior 2015 plan. Similar to the 2015 strategic plan, traditional tools such as a SWOT analysis and strategic retreat were used. In addition, the 2023 process included tools called liberating structures and was iteratively co-produced through a series of virtual meetings over 18 months. Advantages of liberating structures included increased creativity and speed in moving through meeting tasks, increased number of meaningful contributions from AUR members and increased engagement from participants during discussions and meetings. The 2023 AUR strategic plan is provided along with examples of completed goals and those under early implementation. Lessons learned from using these tools for strategic planning can be applied to other society and group meetings. Moving forward, the 2023 strategic plan will be a living document, which will be reviewed at each Board of Directors meeting and periodically adapted.
MeSH term(s)	Humans ; Strategic Planning ; Organizational Objectives
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	1355509-1
ISSN	1878-4046 ; 1076-6332
ISSN (online)	1878-4046
ISSN	1076-6332
DOI	10.1016/j.acra.2023.12.027
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Article ; Online: Failing and Failing Up.

Fessel, David / Lexa, Frank J / Zafar, Hanna M

Journal of the American College of Radiology : JACR

2021 Volume 18, Issue 3 Pt B, Page(s) 465–466

MeSH term(s)	Heart Failure ; Humans
Language	English
Publishing date	2021-03-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2021.02.002
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Article ; Online: Building Effective Teams in the Real World From Traps to Triumph.

Hecht, Elizabeth M / Wang, Sherry S / Fowler, Kathryn / Chernyak, Victoria / Fung, Alice / Zafar, Hanna M

Journal of the American College of Radiology : JACR

2023 Volume 20, Issue 3, Page(s) 377–384

Abstract: Quality patient care and advancements in medical education, investigation, and innovation require effective teamwork. High-functioning teams navigate stressful environments, learning openly from failures and leveraging successes to fuel future ... ...

Abstract	Quality patient care and advancements in medical education, investigation, and innovation require effective teamwork. High-functioning teams navigate stressful environments, learning openly from failures and leveraging successes to fuel future initiatives. The authors review foundational concepts for implementing and sustaining successful teams, including emotional intelligence, trust, inclusivity, clear communication, and accountability. Focus is given to real-world examples and actionable, practical solutions.
MeSH term(s)	Humans ; Quality of Health Care ; Education, Medical ; Patient Care Team ; Learning
Language	English
Publishing date	2023-03-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2022.12.009
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Article ; Online: Use of an Online Crowdsourcing Platform to Assess Patient Comprehension of Radiology Reports and Colloquialisms.

Cho, Joshua K / Zafar, Hanna M / Cook, Tessa S

AJR. American journal of roentgenology

2020 Volume 214, Issue 6, Page(s) 1316–1320

Abstract: OBJECTIVE. ...

Abstract	OBJECTIVE.
MeSH term(s)	Adolescent ; Adult ; Aged ; Comprehension ; Cross-Sectional Studies ; Crowdsourcing ; Diagnostic Imaging ; Female ; Humans ; Male ; Middle Aged ; Patients/psychology ; Terminology as Topic
Language	English
Publishing date	2020-03-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	82076-3
ISSN	1546-3141 ; 0361-803X ; 0092-5381
ISSN (online)	1546-3141
ISSN	0361-803X ; 0092-5381
DOI	10.2214/AJR.19.22202
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Article ; Online: Quality Improvement Report: Design and Implementation of a Radiology E-Consult Service.

Suresh, Kalpana / Hill, Paul A / Kahn, Charles E / Schnall, Mitchell D / Rosen, Mark A / Zafar, Hanna M / Trerotola, Scott O / Cook, Tessa S

Radiographics : a review publication of the Radiological Society of North America, Inc

2023 Volume 43, Issue 12, Page(s) e230139

Abstract: Electronic consultations (e-consults) mediated through an electronic health record system or web-based platform allow synchronous or asynchronous physician-to-physician communication. E-consults have been explored in various clinical specialties, but ... ...

Abstract	Electronic consultations (e-consults) mediated through an electronic health record system or web-based platform allow synchronous or asynchronous physician-to-physician communication. E-consults have been explored in various clinical specialties, but relatively few instances in the literature describe e-consults to connect health care providers directly with radiologists.The authors outline how a radiology department can implement an e-consult service and review the development of such a service in a large academic health system. They describe the logistics, workflow, turnaround time expectations, stakeholder management, and pilot implementation and highlight challenges and lessons learned.
MeSH term(s)	Humans ; Quality Improvement ; Referral and Consultation ; Software ; Communication ; Radiology
Language	English
Publishing date	2023-11-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	603172-9
ISSN	1527-1323 ; 0271-5333
ISSN (online)	1527-1323
ISSN	0271-5333
DOI	10.1148/rg.230139
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Article ; Online: Population Health Management in Radiology: Economic Considerations.

Dako, Farouk / Cook, Tessa / Zafar, Hanna / Schnall, Mitchell

Journal of the American College of Radiology : JACR

2023 Volume 20, Issue 10, Page(s) 962–968

Abstract: There is a growing emphasis on population health management (PHM) in the United States, in part because it has the worst health outcomes indices among high-income countries despite spending by far the most on health care. Successful PHM is expected to ... ...

Abstract	There is a growing emphasis on population health management (PHM) in the United States, in part because it has the worst health outcomes indices among high-income countries despite spending by far the most on health care. Successful PHM is expected to lead to a healthier population with reduced health care utilization and cost. The role of radiology in PHM is increasingly being recognized, including efforts in care coordination, secondary prevention, and appropriate imaging utilization, among others. To further discuss economic considerations for PHM, we must understand the evolving health care payer environment, which combines fee-for-service and increasingly, an alternative payment model framework developed by the Health Care Payment Learning and Action Network. In considering the term "value-based care," perceived value needs to accrue to those who ultimately pay for care, which is more commonly employers and the government. This perspective drives the design of alternative payment models and thus should be taken into consideration to ensure sustainable practice models.
MeSH term(s)	United States ; Reimbursement Mechanisms ; Population Health Management ; Fee-for-Service Plans ; Delivery of Health Care ; Radiology
Language	English
Publishing date	2023-08-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2023.07.016
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Zs.A 6636: Show issues

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Article ; Online: Lessons From the Free-Text Epidemic: Opportunities to Optimize Deployment of Imaging Clinical Decision Support.

Fried, Jessica G / Pakpoor, Jina / Kahn, Charles E / Zafar, Hanna M

Journal of the American College of Radiology : JACR

2021 Volume 18, Issue 3 Pt B, Page(s) 467–474

Abstract: Objective: The Protecting Access to Medicare Act of 2014 requires clinicians to consult Appropriate Use Criteria (AUC) when ordering advanced imaging procedures. Free-text order indications are available when there is no applicable structured indication ...

Abstract	Objective: The Protecting Access to Medicare Act of 2014 requires clinicians to consult Appropriate Use Criteria (AUC) when ordering advanced imaging procedures. Free-text order indications are available when there is no applicable structured indication but are unscored by the AUC. We determined the proportion of free-text indications among all advanced imaging orders and the proportion of free-text indications that could be mapped to a single structured indication. Methods: All outpatient advanced diagnostic imaging orders placed in a large multisite health system were recorded after initial AUC deployment (November 20, 2017, to December 19, 2017). Clinicians were prompted upon order entry to select a structured indication or enter a free-text indication. We manually reviewed the two imaging examinations with the highest rate of free-text indications: enhanced CT abdomen/pelvis and unenhanced CT head. Regression analysis examined differences in patient-, imaging-, context-, and provider-level characteristics between scored and unscored examinations. Results: Among all 39,533 orders for advanced imaging procedures, 59% (23,267 of 39,533) were unscored by the system. The regression model c-statistic (0.50-0.55) demonstrated poor model fit to evaluate for differences between scored and unscored examinations. Free-text indications were found in 71% (16,440 of 23,267) of unscored examinations and 42% (16,440 of 39,533) of all examinations. Manual review of all 1,693 CT abdomen/pelvis and 1,527 CT head examinations with free-text indications revealed that 3,132 free-text indications (97%) could be mapped to a single existing structured indication. Discussion: Of all initially placed outpatient advanced imaging procedure orders, 42% included free-text indications and 97% of manually reviewed free-text indications could be mapped to a single structured indication.
MeSH term(s)	Aged ; Decision Support Systems, Clinical ; Epidemics ; Humans ; Medical Order Entry Systems ; Medicare ; Tomography, X-Ray Computed ; United States
Language	English
Publishing date	2021-02-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2021.01.002
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Article ; Online: Impact of Artificial Intelligence-Assisted Indication Selection on Appropriateness Order Scoring for Imaging Clinical Decision Support.

Shreve, Lauren A / Fried, Jessica G / Liu, Fang / Cao, Quy / Pakpoor, Jina / Kahn, Charles E / Zafar, Hanna M

Journal of the American College of Radiology : JACR

2023 Volume 20, Issue 12, Page(s) 1258–1266

Abstract: Purpose: The aim of this study was to assess appropriateness scoring and structured order entry after the implementation of an artificial intelligence (AI) tool for analysis of free-text indications.: Methods: Advanced outpatient imaging orders in a ... ...

Abstract	Purpose: The aim of this study was to assess appropriateness scoring and structured order entry after the implementation of an artificial intelligence (AI) tool for analysis of free-text indications. Methods: Advanced outpatient imaging orders in a multicenter health care system were recorded 7 months before (March 1, 2020, to September 21, 2020) and after (October 20, 2020, to May 13, 2021) the implementation of an AI tool targeting free-text indications. Clinical decision support score (not appropriate, may be appropriate, appropriate, or unscored) and indication type (structured, free-text, both, or none) were assessed. The χ Results: In total, 115,079 orders before and 150,950 orders after AI tool deployment were analyzed. The mean patient age was 59.3 ± 15.5 years, and 146,035 (54.9%) were women; 49.9% of orders were for CT, 38.8% for MR, 5.9% for nuclear medicine, and 5.4% for PET. After deployment, scored orders increased to 52% from 30% (P < .001). Orders with structured indications increased to 67.3% from 34.6% (P < .001). On multivariate analysis, orders were more likely to be scored after tool deployment (odds ratio [OR], 2.7, 95% CI, 2.63-2.78; P < .001). Compared with physicians, orders placed by nonphysician providers were less likely to be scored (OR, 0.80; 95% CI, 0.78-0.83; P < .001). MR (OR, 0.84; 95% CI, 0.82-0.87) and PET (OR, 0.12; 95% CI, 0.10-0.13) were less likely to be scored than CT (; P < .001). After AI tool deployment, 72,083 orders (47.8%) remained unscored, 45,186 (62.7%) with free-text-only indications. Conclusions: Embedding AI assistance within imaging clinical decision support was associated with increased structured indication orders and independently predicted a higher likelihood of scored orders. However, 48% of orders remained unscored, driven by both provider behavior and infrastructure-related barriers.
MeSH term(s)	Humans ; Female ; Adult ; Middle Aged ; Aged ; Male ; Decision Support Systems, Clinical ; Artificial Intelligence ; Medical Order Entry Systems ; Diagnostic Imaging ; Radionuclide Imaging
Language	English
Publishing date	2023-06-28
Publishing country	United States
Document type	Multicenter Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2023.04.016
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Article ; Online: Reply to letter to the editor: "clinical evaluation of ureteral pseudodiverticulosis".

Morgan, Matthew A / Zafar, Hanna M / Papanicolaou, Nicholas / Ramchandani, Parvati

Abdominal radiology (New York)

2019 Volume 44, Issue 7, Page(s) 2677

MeSH term(s)	Carcinoma, Transitional Cell ; Humans ; Ureter ; Urinary Bladder Neoplasms
Language	English
Publishing date	2019-04-25
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2839786-1
ISSN	2366-0058 ; 2366-004X
ISSN (online)	2366-0058
ISSN	2366-004X
DOI	10.1007/s00261-019-02040-0
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Article ; Online: Early Impact of Pennsylvania Act 112 on Follow-up of Abnormal Imaging Findings.

Mattay, Govind S / Mittl, Gregory S / Zafar, Hanna M / Cook, Tessa S

Journal of the American College of Radiology : JACR

2020 Volume 17, Issue 12, Page(s) 1676–1683

Abstract: Objective: Pennsylvania Act 112 requires diagnostic imaging facilities to directly notify outpatients about significant imaging abnormalities that require follow-up care within 3 months. The effects of Act 112 on patient care are unclear. We sought to ... ...

Abstract	Objective: Pennsylvania Act 112 requires diagnostic imaging facilities to directly notify outpatients about significant imaging abnormalities that require follow-up care within 3 months. The effects of Act 112 on patient care are unclear. We sought to characterize follow-up discussions and care received by outpatients with significant imaging abnormalities as defined by Act 112. Methods: We evaluated findings flagged for patient notification under Act 112 at our institution over a 1-month period. We analyzed findings for radiologic reporting, follow-up discussions between patients and ordering providers, and follow-up medical care provided. Results: Follow-up discussions were documented for 87% of findings (n = 205 of 235) and occurred on average 6.0 days after imaging examinations were performed. Follow-up discussions directly attributable to the Act 112 letter occurred in 0.4% of findings. Follow-up care was provided for 74% of findings on average 31.3 days after imaging examinations were performed. Provider-initiated follow-up discussions occurred earlier and were associated with shorter time to follow-up care when compared with patient-initiated discussions. Direct contact of ordering provider by interpreting radiologist was a significant predictor of occurrence of follow-up discussions and length of time to follow-up care. Discussion: Act 112 had a small impact at our institution on improving completed follow-up for abnormal imaging findings. Our results also imply that health systems should encourage timeliness of patient-provider discussions of abnormal imaging findings and facilitate direct radiologist communication with ordering providers. Future studies should evaluate the impact of Act 112 in different practice settings to understand its broader impact on follow-up care.
MeSH term(s)	Communication ; Follow-Up Studies ; Humans ; Pennsylvania ; Radiologists ; Radiology
Language	English
Publishing date	2020-06-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2020.05.014
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