Next Level of Care Protocols in Radiology: Improving Patient Access to Care.

OBJECTIVE: To introduce a novel next level of care (NLC) protocol used in our breast imaging practice to bypass additional imaging and image-guided biopsy orders and to examine the impact of NLC on breast biopsy wait times compared with thyroid biopsy wait times, which do not use NLC. METHODS: Our institutional review board deemed this retrospective analysis to be exempt. NLC was implemented for breast imaging in late 2014. Two 6-month periods before and after the COVID-19 shutdown were sampled and compiled. Data were queried from departmental database and electronic health record for all breast and thyroid biopsies during this time. Time to biopsy (TTB) was defined as the number of days from the diagnostic imaging evaluation recommending the biopsy to the completion of the biopsy. To determine the effect of NLC, TTB was compared between breast and thyroid biopsies. RESULTS: Of the 1,114 breast biopsies and 154 thyroid biopsies included, the mean TTB was 9 days (95% confidence interval 8.4-9.3) for breast and 23 days (95% confidence interval 20.5-25.0) for thyroid. There was a 61% reduction in the mean TTB for patients in the breast group compared with patients in the thyroid group. The effect of the NLC was comparable among different races and ethnicities in the breast group, but a significantly higher mean TTB (24% higher, P = .025) was observed for thyroid biopsies in Black patients compared with thyroid biopsies in Hispanic patients. CONCLUSION: NLC protocol facilitates imaging evaluations and reduces the time interval to image-guided biopsies.

Recurrent Malignant Melanoma Detected on 18F-Fluciclovine PET/CT Imaging for Prostate Cancer.

A 66-year-old man presented with biochemical recurrence of prostate cancer and underwent F-fluciclovine PET/CT to detect sites of recurrence. He had a history of resected truncal stage IIIC malignant melanoma, with bilateral axillary node involvement on sentinel node biopsy, in complete remission for 3 years. F-fluciclovine PET/CT demonstrated an incidental fluciclovine-avid right axillary node (SUVmax = 4.3). Diagnostic sampling confirmed recurrent malignant melanoma.

Minimising waste in the food and drink sector: using the business club approach to facilitate training and organisational development.

The aim of the East Anglian Waste Minimisation in the Food And Drink Industry Project was to develop waste minimisation capability in food and drink sector companies by providing a structured training programme and consultancy support to participating members of a business club. The business club forum provided the structure within which interactive training and development sessions were delivered. Expertise and assistance in implementing waste minimisation and waste management programmes was given to member companies at their sites. The project resulted in pound 1,800,000 per annum of identified savings with pound 1,100,000 of verified savings already achieved. Training and development contributed fundamentally to these project outcomes and achievements. The structured training package used three different approaches or methods. Teaching and workshop sessions were used to present interactive training on waste minimisation practice. These were supplemented by interactive 'report-back' sessions where the 'project champions' presented progress reports to the club on waste minimisation at their sites. An overview of the business club approach is described, together with an account of the successes and challenges of applying a structured training and development programme and the barriers to waste minimisation that were overcome. Training effectiveness was measured according to reaction, learning, application and impact.