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Abuse of STAT

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  • Abuse of STAT

    I’m in radiology and we constantly get STAT request for just about any body parts. When you read the history most are bogus. They just put STAT to get it in before they go home or before the weekend or before they go on a trip.

    Everyone thinks their patient need STAT scans. And there is no real threshold to make and order a STAT scan of any body part.

    So, what do you think about charging more for STAT scans? It diverts techs and radiologist away to have to complete these ‘non STAT’ STATs studies.

    Right now the pay is the same for STATs or non STATs. But if STAT exams were charged more, maybe doctors, PAs, NPs (and even patients) might think a little more about ordering STATs.

  • #2
    SuperSTAT! And call with report.

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    • #3
      I rarely use STAT. Only when I need to rule out something more urgent that may involve additional work-up/hospitalizations (i.e. r/o DVT, diverticulitis). Typically I'm only ordering STAT to try to keep them out of the ER and manage outpatient, if possible. Most of my exams don't require STAT orders, and the radiologist around here typically get me results within 24 hours, so there isn't really a need for that.

      Outpatient primary care.

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      • #4
        I typically dont order stat unless I think it is a fracture, dvt, appy or toenail pain.

        The issue in my neck of the woods, that if I order a cxr thinking someone might have covid pneumonia, I get the report in 6-7 days. Somewhat useless at that time. Same time period for follow ups and less urgent problems. Usually patients call every day until they get their results.

        Outpatient primary care.

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        • #5
          This week I had a STAT biopsy. Slides came out on Tuesday because of transport and processing. When I looked at the case Tuesday morning, there was no note written from the Friday visit.

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          • #6
            I agree its an issue. As a surgeon at our facility, if I have a study that needs to be performed within 12 hours, I pretty much have to order as STAT although it is not truly needed "STAT." Our other options are "ASAP" and "Routine." Not sure what ASAP is supposed to mean, but most likely they will get it done within 18 hours or so in my experience. Order a study "Routine" if you want it done in 48 hours.

            This also applies to labs, etc.
            Vicious cycle. One reason STAT has to be used to get a test done within a few hours is because it has to compete with all of the other "STAT" orders out there.

            Unfortunately I dont know if charging more for STAT scans will do anything because those ordering are not paying for them. Same with daily labs on stable hospitalized patients. If those doing the ordering had to pick every order from a menu with a price that the one ordering had to pay, perhaps we would be able to live without daily phosphorus levels on every patient, and maybe it would be ok to get an image performed "Routinely" in 12 hours rather that STAT in 3 hours.

            With that said, if I do have a study that needs to be done STAT in order to make a clinical decision, I certainly dont want to have to pay out of my pocket for my patient's care just because they are more acute than others. Tough spot.

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            • #7
              Our TAT for pretty much everything that's not a routine joint MR or nuclear medicine is 4-6 hours. Usually less, but it depends on the radiologist. STATs are read within the hour.

              Most irritating is the outpatient stat ordered by someone who is un-pageable. If you order something stat, be available for a stat result.

              Other irritating one is the stat metastatic workup. Some statuses are unavoidable if coming from the ER (I believe that's the default setting there, which makes sense).

              We've tried to have different statuses for urgent and pending discharge in our PACS by having a different color code. It helps our workflow, but I actually don't know if the clinicians order them differently in Epic.

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              • #8
                I remember ranting about this in residency.

                When everything is stat, nothing is stat.

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                • #9
                  In 21 years, I've never used the stat function, but thanks for reminding me that it exists.

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                  • #10
                    Yeah I only used stat to eval for peritoneal exam or something that would change management. I also call down to the radiology department to let people know it was super stat.

                    (I also wrote down pertinent findings and what I was looking for in the comment section in hopes the radiologist would read it)

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                    • #11
                      I am also outpatient family practice and rarely ever use stat. We have a way to Mark things priority if we would like them done the same day but not necessarily right away. Basically I only use that one I'm trying to do something outpatient that would keep somebody out of an emergency room. Sometimes it's ridiculous the hoops we have to jump through in the outpatient world to get things done in a timely fashion. When the patient could have gone to the emergency room had all the tests and results and the treatment and been home in a few hours. And you wonder why people abuse emergency rooms! They deliver!

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                      • #12
                        The rule at my VA is if you want something stat from outpatient (not the ER), you must call and talk with the radiologist. Takes 2 minutes but it keeps people from doing it unless they truly have a good reason. Plain films get done and read within the hour when ordered routine anyway so only needed for CT scan/MRI/ultrasound

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                        • #13
                          STAT PT renewals, STAT Home Health visits, STAT labs, STAT STAT STAT.

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                          • #14
                            stat mask exemption please

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                            • #15
                              fwiw i work in an ED where every radiology study MUST be ordered stat of the techs literally will not do it, but we are not allowed to use the language of STAT with respect to consults.


                              *shrugs?*

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