Backstop (Quality & Safety Initiative)

UR Imaging is leading a wide-reaching quality initiative to minimize delays in diagnosis of malignancy or aneurysm through radiology recommendation tracking. 

The Backstop initiative, which ensures patients with potentially serious conditions receive appropriate and timely follow-up care, centers on improving communication between primary care providers (PCPs), oncologists, and radiologists. 

As of Aug. 17, 2017, the Backstop Clinical Navigator has initiated contact with offices of PCPs and select specialists to alert them of patients who have not obtained recommended imaging tests one month after the referrals. Results from a recent pilot of this initiative at FF Thompson reduced potential delays in diagnosis by 74 percent.

“We want to ensure patients do not ‘fall through the cracks,’ reducing the risk of delay in diagnosis, a form of preventable medical error,” said Ben Wandtke, M.D. M.S., chief of diagnostic imaging at Thompson Health (pictured), and co-developer of the Backstop initiative. “Diagnosing cancer in an early stage compared to a late stage can increase a patient’s chance for successful treatment by 50 percent. We feel strongly that every cancer patient deserves their best chance for a cure.”

“I am extremely excited that our patients and providers will be able to participate in this initiative. This project is a major step forward for improved patient safety and risk reduction,” said Stephen Judge, M.D., medical director of the Primary Care Network.

About Backstop

The Backstop initiative is an extension of a pilot program that was developed at Thompson Health. The Backstop team built a database to track patients with incidental findings who did not complete recommendations for follow-up care.

A combination of calls and letters allowed physicians and support staff to dramatically improve patient compliance with recommended follow-up imaging studies, increasing completion of recommended follow-up by 52 percent for patients tracked in the Backstop program. Thompson now identifies appropriate follow-up compliance for more than 86 percent of all imaging recommendations, higher than other health systems have reported in the medical literature. 

With that success, UR Medicine has expanded the program, with financial support of an MCIC Patient Safety Award, to all affiliate hospitals and outpatient imaging sites.

“This is a great program to reduce the chance of patient harm from a missed or delayed diagnosis of cancer.  For office practice, diagnosis failures are the largest cause of malpractice losses and failure to follow-up on a potentially significant test finding is much more of a problem than failure to make the correct diagnosis,” said Robert Panzer, M.D., chief quality officer.

Expanding the Backstop program throughout the UR Medicine affiliated network will increase the number of patients benefiting from this quality initiative tenfold, according to Wandtke. In the future, he said, the multi-stage tracking model could be modified for other applications, expanding into pathology or cardiology follow-up tracking, for example. Wandtke and Gallagher recently published their findings in the American Journal of Roentgenology.

Backstop Project Leader: Dr. Ben Wandtke, MD, MS
Backstop Project Manager: Kristen Hans, RN, MS
Backstop Clinical Coordinator:  Aubry Parker

For questions and more information about Backstop, contact BackStop@urmc.rochester.edu.