Benefits of integration of radiology services across a pediatric health care system with locations in multiple states.

BACKGROUND: Integration was implemented of previously independently practicing pediatric radiology services across a pediatric health care system with sites 1,000 miles apart. OBJECTIVE: The purpose of this manuscript is to describe the process utilized to integrate imaging services across our enterprise and to study the direct effects on report turnaround time and other parameters. MATERIALS AND METHODS: Parameters were evaluated both the year before integration as well as the 2 years following integration and compared for improvement. Parameters studied included report turnaround time, academic productivity (as measured by peer review publications per year), and degree of sub-subspecialization within pediatric radiology (as measured by the percentage of neuroimaging CT and MRI studies read by pediatric neuroradiologists). RESULTS: Comparing pre- to post-integration measures, the median report turnaround time decreased from 2.3 h to 1.1 h (52.1% improvement), the percentage of neuroimaging studies read by neuroimaging faculty increased from 15.0% to 86.6% (477% improvement), and peer review publication by calendar year increased from 3 to 30 (1,000% improvement). Other benefits included increased hours of in-house coverage and execution on multiple quality improvement efforts. CONCLUSION: A pediatric health care system successfully integrated radiology services across multiple previously non-integrated locations into one functional group. This integration was associated with a positive effect on multiple parameters.

Hip ultrasound.

Sonography has been widely utilized for several decades in the diagnosis and follow-up of developmental dysplasia of the hip due to its ability to visualize the nonossified femoral head and portions of the acetabulum in neonates, dynamic capabilities, accuracy, and lack of nonionizing radiation. Furthermore, hip sonography is also used throughout parts of the world to diagnose and guide intervention for both children and adults. The hip joint, tendons, and periarticular structures can be delineated with sonography in a variety of congenital, developmental, infectious, inflammatory, arthritic, traumatic, and neoplastic disorders. The following discussion focuses on the sonographic technique and imaging characteristics of congenital and developmental anomalies of the hip in children, as well as the sonographic evaluation of the hip joint and tendons.