TH Backstop

Dr. Ben Wandtke Chief of Diagnostic Imaging for Thompson Hospital, looks at a patients film transferred by the fiber ring.

An innovative quality-improvement program developed at UR Medicine Thompson Health has shown dramatic results in making sure patients with potentially serious conditions receive appropriate, timely follow-up care that could save their lives.

Called Backstop, the initiative launched in 2015 under the leadership of Chief of Diagnostic Imaging Dr. Ben Wandtke and Thompson’s former quality improvement coordinator.

The two set out to determine whether a multi-stage tracking system could improve communication between healthcare providers, reducing the risk of delay in diagnosis related to inconsistent communication and the important tracking of radiology follow-up recommendations.

The initiative centered on “incidental findings.” An example could be a lung nodule detected when a patient has a CT scan for another reason, such as chest pain. While many incidental findings will cause patients no harm, others can represent early stages of cancer.

The Backstop team entered patients’ radiology recommendations into a specially-created database and identified which patients did not obtain the recommended follow-up care. Via a multi-step process involving calls and letters from the program’s clinical coordinator, Thompson was able to dramatically improve patient compliance with recommendations.

In fact, over the course of 13 months, completion of recommended follow-up increased by 52 percent. The number of patients at risk for delay in diagnosis was reduced by 74 percent. As noted in a recent issue of American Journal of Roentgenology, Thompson now identifies appropriate follow-up compliance for more than 86 percent of all radiology recommendations. That's higher than any other health system has reported in medical literature.

Donna Gurnell, for one, is grateful.

After illness and a number of other things led the Lima woman to miss a recommended follow-up CT screening for lung cancer, she received a reminder and called the Backstop program’s clinical coordinator, who worked with her primary care provider’s office to get her exam authorization renewed.

Gurnell says it was good to know Thompson would follow up to make sure she didn’t fall through the cracks and could get checked out to make sure she is OK.

“They worked really hard to keep up with me on these appointments, especially when I was ill at the time,” Gurnell says.

For some patients, the impact of a follow-up assessment can be profound.

“Diagnosing cancer in an early stage compared to a late stage can increase a patient’s chance for successful treatment by 50 percent,” Wandtke says.

Wandtke is leading a team to expand the Backstop program throughout UR Medicine. This, he says, will increase the number of patients benefitting from this quality initiative tenfold.