Early surveying of medical staff interest in Choosing Wisely identified MRI ordering as an area of focus. Medical staff at Island Health and in communities across the island are interested in reducing unnecessary testing for patients, reducing overuse of resources, and ensuring we get the right image at the right time.
To aid in point of care decision making on MRI ordering appropriateness, the Island Health Medical Imaging department have developed a MRI Checklist for Family Physicians and Nurse Practitioners in the community. The checklist is to be completed and submitted alongside the newly updated MRI requisition form.
The criteria aligns with Choosing Wisely Canada recommendations for MRI ordering and focuses on:
- MRI for lumbar spine
- MRI for knee and hips
- MRI for shoulder
- MRI for headaches
In addition to being consistent with Choosing Wisely Canada recommendations, the checklist is in alignment with provincial initiatives to improve MRI ordering appropriateness and similar checklists are available on the Lower Mainland and at Northern Health.
You can download the checklist by clicking here or using the link in the table below.
To learn more, additional documentation detailing the appropriateness criteria and the new process have been developed by the Island Health Medical Imaging department and are available in the PDFs linked in the table below.
The updated MRI requisition, checklist, and appropriateness guidelines are also available in FPSC Pathways.
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MRI Requisition |
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MRI Checklist for referring Family Physicians and Nurse Practitioners |
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Why Choose Wisely for MRI?
Canadian studies suggest that up to 20% of medical imaging is inappropriate or non-essential.
Ensuring appropriate ordering of MRI has significant benefits for patients and providers. Reducing the number of inappropriate MRI requests will shorten wait times, lessen patient anxiety experienced while waiting for results, and ensure providers are equipped with the results needed to provide quality care.
Radiology and medical imaging make a sizeable contribution to the healthcare sectors total green house gas emissions. Annually, a single MRI machine is estimated to be the equivalent to 26 four-person households. Ensuring appropriate use and reducing low-value imaging is a recommended and effective strategy to mitigate the environmental impact of MRI as we work together towards a greener future.
Additional Resources
For community providers, consider displaying one of our Choosing Wisely at Island Health Patent-Centred Public Awareness Campaign posters on medical imaging in your waiting room to aid in setting patient expectations around appropriate imaging. Choosing Wisely Canada have also developed several patent pamphlets to help explain when a test is and isn’t necessary.
Improvement Initiatives
The Choosing Wisely at Island Health Oversight Committee are interested in hearing from community providers, medical staff, and multidisciplinary team members who are using quality improvement to improve MRI appropriateness. Email MedStaffQI@islandhealth.ca to share your ideas or projects and have them highlighted on the Medical Staff website.
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Click here to return to the main Choosing Wisely at |
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Learn more about the Choosing Wisely at Island Health Patient-Centred Public Awareness Campaign |