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- Know when (signs/symptoms) to return to the ED or seek medical attention
- Strain urine to identify definitive stone passage
- Acquire your images if at an outside hospital with plans for referral
- Do not be concerned about prevention measures at this point in time, as this scan be addressed after the stone episode has resolved
- Know that your stone may still be present even if the pain has resolved
The AUA Resource Toolkit for Stewardship of Imaging highlights several important topics for imaging stewardship with numerous hyperlinks to other great resources. Many of these topics were reviewed at today’s Quality Improvement Summit, including (i) implementation of low-dose renal colic protocol CT imaging, (ii) reducing potentially avoidable staging imaging in lower risk prostate cancer patients, (iii) clinical decision support for advanced imaging (R-SCAN), (iv) development and implementation of prostate MRI programs, and (v) the American College of Radiology programs to support imaging stewardship. Other important initiatives on the website not discussed at the QI Summit today include implementation of ultrasound in urology practice and the imaging stewardship QI project library. Importantly, the AUA has partnered with the American Institute of Ultrasound in Medicine to develop accreditation programs for practices in order to demonstrate performance of high quality imaging. This section also highlights several documents, including a practice guideline for performing ultrasonography in the urology practice, standards for ultrasonography accreditation, and training guidelines for performing ultrasound examinations in clinical practice. The imaging stewardship QI project library provides additional resources regarding multiple CT scenarios, a framework for conducting a QI project in urology practice, a clinical pathway for acute nephrolithiasis for pediatric patients, and a document discussing diagnostic efficacy and radiation modulation of imaging for renal cell carcinoma.
The AUA Resource Toolkit for Stewardship of Imaging can be found at:
Speaker(s): Kevan Sternberg, University of Vermont, Burlington, VT, USA; Arjun Venkatesh, Yale University, New Haven, CT, USA; Erick Remer, Cleveland Clinic Foundation, Cleveland, OH, USA; Rebecca Smith-Bindman, University of California-San Francisco, San Francisco, CA, USA
Written by: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre, Twitter: @zklaassen_md, at the AUA Quality Improvement Summit - October 21, 2017- Linthicum, Maryland