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Fawzy NA, AlMuslem NF, Altayeb A, Ghosheh MJ, Khoumais NA. Improving Time to Diagnostic Resolution in the Breast Imaging Service: A Tertiary Center's Experience and Process of Improvement. JOURNAL OF BREAST IMAGING 2023; 5:555-564. [PMID: 38416920 DOI: 10.1093/jbi/wbad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Indexed: 03/01/2024]
Abstract
OBJECTIVE Breast imaging services often experience a significant degree of variability in patient flow, leading to delay in time to diagnostic resolution, commonly referred to as time to resolution (TTR). This study applies Lean Six Sigma Methodology (LSSM) to reduce TTR and enhance patient outcomes. METHODS This study was IRB-approved. A baseline audit was done using cases of mammographic recalls (BI-RADS 0) to measure baseline TTR. Multidisciplinary meetings with all members of the breast imaging service, alongside a study of patient complaint data, were utilized to identify issues that were causing prolonged TTR. Following that, possible solutions were proposed and implemented. A post-implementation audit was conducted, and the resulting TTRs were compared. Significant differences in TTR between the pre- and post-solution implementation were assessed using the Mann-Whitney U test. RESULTS During the baseline audit of 8 months, 589 cases of mammographic recalls (BI-RADS 0) were identified, and the resulting average TTR was 86.3 days. During the post-implementation period of 3 months, 370 mammographic recalls (BI-RADS 0) occurred, with a resulting average TTR of 36.0 days. After applying LSSM, TTR was reduced by 58.3% (P < 0.01). Some changes implemented included training the coordinators, establishing a rapid diagnostic clinic using previously underutilized equipment, and having radiologists assigned full-time to the breast imaging service. CONCLUSION Our team has successfully managed to identify various causes behind the prolonged TTR using LSSM. Team collaboration was essential to study and decide on a more achievable TTR.
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Affiliation(s)
- Nader A Fawzy
- Alfaisal University, College of Medicine, Riyadh, Saudi Arabia
| | - Noor F AlMuslem
- Qatif Central Hospital, Department of Radiology, Al Qatif, Saudi Arabia
| | - Afaf Altayeb
- Alfaisal University, College of Medicine, Riyadh, Saudi Arabia
| | | | - Nuha A Khoumais
- King Faisal Specialist Hospital and Research Center, Department of Radiology, Riyadh, Saudi Arabia
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Felsen A, McClelland A, Kobi M, Bello JA, Burns J. Health Systems Science - A Primer for Radiologists. Acad Radiol 2023; 30:2079-2088. [PMID: 36966069 DOI: 10.1016/j.acra.2023.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 03/27/2023]
Abstract
Health systems science (HSS) is an educational framework designed to promote improved care through enhanced citizenship and the training of systems-fluent individuals trained in the science of health care delivery. HSS education in residency builds upon foundations established during medical school, emphasizing practical skills development, and fostering a growth mindset among trainees. The HSS framework organizes elements of system-based practice for radiology trainees, promoting practice-readiness for providing safe, timely, effective, efficient, equitable and patient centered radiological care. This paper serves as a primer for radiologists to understand and apply the HSS framework. Additionally, we highlight radiology-specific curricular elements aligned with the HSS framework, and provide teaching resources both for classroom education and for resident self-study.
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Affiliation(s)
- Amanda Felsen
- Albert Einstein College of Medicine, Montefiore New Rochelle Hospital; Bronx, NY
| | - Andrew McClelland
- Department of Radiology, NYU Grossman School of Medicine; New York, NY
| | - Mariya Kobi
- Department of Radiology, Columbia University Medical Center; New York, NY
| | | | - Judah Burns
- Department of Radiology, Montefiore Medical Center; Bronx, NY; Albert Einstein College of Medicine; Bronx, NY.
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More R, Dunn E, Dunwell S. Improving radiology: a whole-system opportunity. Clin Radiol 2023; 78:395-400. [PMID: 36935256 DOI: 10.1016/j.crad.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 01/09/2023] [Accepted: 01/25/2023] [Indexed: 03/06/2023]
Abstract
In this article, we set out the current context and case for change in radiology in England and how quality-improvement approaches can support the development of sustainable Imaging services and networks to meet the challenges faced now and in the future.
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Affiliation(s)
- R More
- Xytal Health Management Ltd, The Vineyard, Little Norton, Norton Sub Hamdon, Somerset TA14 6TE, UK.
| | - E Dunn
- Xytal Health Management Ltd, The Vineyard, Little Norton, Norton Sub Hamdon, Somerset TA14 6TE, UK
| | - S Dunwell
- Xytal Health Management Ltd, The Vineyard, Little Norton, Norton Sub Hamdon, Somerset TA14 6TE, UK
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Utilization of a cloud-based radiology analytics platform to monitor imaging volumes at a large tertiary center. Eur J Radiol Open 2022; 9:100443. [PMID: 36217502 PMCID: PMC9547187 DOI: 10.1016/j.ejro.2022.100443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/31/2022] [Accepted: 09/29/2022] [Indexed: 11/15/2022] Open
Abstract
Rationale and objective In this study, we evaluate the ability of a novel cloud-based radiology analytics platform to continuously monitor imaging volumes at a large tertiary center following institutional protocol and policy changes. Materials and methods We evaluated response to environmental factors through the lens of the COVID-19 pandemic. Analysis involved 11 CT/18 MR imaging systems at a large tertiary center. A vendor neutral, cloud-based analytics tool (CBRAP) was used to retrospectively collect information via DICOM headers on imaging exams between Oct. 2019 to Aug. 2021. Exams were stratified by modality (CT or MRI) and organized by body region. Pre-pandemic scan volumes (Oct 2019-Feb. 2010) were compared with volumes during/after two waves of COVID-19 in Illinois (Mar. to May 2020 & Oct. to Dec. 2020) using a t-test or Mann-Whitney U test. Results The CBRAP was able to analyze 169,530 CT and 110,837 MR images, providing a detailed snapshot of baseline and post-pandemic CT and MR imaging across the radiology enterprise at our tertiary center. The CBRAP allowed for further subdivision in its reporting, showing monthly trends in average scan volumes specifically in the head, abdomen, spine, MSK, thorax, neck, GU system, or breast. Conclusion The CBRAP retrieved data for 300,000 + imaging exams across multiple modalities at a large tertiary center in a highly populated, urban environment. The ability to analyze large imaging volumes across multiple waves of COVID-19 and evaluate quality-improvement endeavors/imaging protocol changes displays the usefulness of the CBRAP as an advanced imaging analytics tool.
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Key Words
- CBRAP, Cloud-based analytics tool
- COVID-19
- CT, Computed tomography
- Cloud-based analytics
- Computed tomography
- GU, Genitourinary
- HEENT, Head, eyes, ear, nose, throat
- MRI, Magnetic resonance imaging
- MSK, Musculoskeletal
- Magnetic resonance imaging
- Process improvement
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Fergus J, Nijhawan K, Feinberg N, Hieromnimon M, Navuluri R, Zangan S, Funaki BS, Ahmed O. Implementation of a hybrid angiography-CT system: increased short-term revenue at an academic radiology department. Abdom Radiol (NY) 2021; 46:5428-5433. [PMID: 34228198 DOI: 10.1007/s00261-021-03204-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE To analyze the financial impact following implementation of a hybrid Angio-CT system at a tertiary care academic medical center. METHODS Aggregate case types and volumes were compared 24 months before and 12 months after a hybrid Angio-CT system replaced a traditional interventional C-arm angiography suite at an academic medical center. Procedure revenues from this 36-month study period were derived from five payors mixes (Medicare, Medicaid, commercial insurance, out-of-pocket and managed care program) and Medicare-rate adjusted to each individual payor types. RESULTS Average case volume per month increased 12% in the hybrid Angio-CT suite when compared to the previous traditional angiography suite (P < 0.05). The variety of IR procedures in the hybrid Angio-CT suite also expanded to include more complex interventional radiology and interventional oncology procedures; the breadth of cases performed in the hybrid Angio-CT suite were associated with CPT codes of higher rates (average CPT value/case increased from $2,334.61 to $2,567.25). The estimated average annual revenue of the hybrid Angio-CT suite increased 23% as compared to previous traditional angiography suite. CONCLUSION A hybrid Angio-CT system is a financially feasible endeavor at a tertiary care academic medical center that facilitated higher complexity procedure codes and increased procedure-related revenue.
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Meyl TP, Berghöfer A, Blatter T, Heverhagen JT, de Bucourt M, Maurer MH. Software-Based Evaluation of Optimization Potential for Clinical MRI Scanners in Radiology. ROFO-FORTSCHR RONTG 2021; 194:391-399. [PMID: 34687027 DOI: 10.1055/a-1659-8821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of the study was to use a software application to analyze the examination times and changeover times of two clinically highly applied MRI scanners at a university hospital for radiology and to evaluate whether this could result in optimization potential for examination planning in the daily clinical routine of MRI diagnostics. MATERIALS AND METHODS Based on the newly developed software application "Teamplay Usage" (Siemens Healthineers, Germany), the examinations carried out on two MRI scanners (1.5 T and 3 T) were investigated within an analysis period of 12 months with regard to the type of examination and its duration. In addition, compliance with the previously defined planning time (30, 45, 60 min.) was checked and deviations were analyzed. In addition, the changeover times between the examinations were determined and a possible influence due to the exchange of MRI coils was investigated for a selection of change combinations. RESULTS For the total of 7184 (1.5 T: 3740; 3 T: 3444) examinations included in the study, the median examination time was 43:02 minutes (1.5 T: 43:17 min.; 3 T: 42:45 min.). The ten most frequent types of examinations per MRI scanner were completed within the predefined plan time of 54.5 % (1.5 T) and 51.9 % (3 T), taking into account a previously defined preparation and post-processing time of 9 minutes per examination. Overall, more time was spent on examinations with a planned time of 30 minutes, whereas the majority of the examinations planned with 45 minutes were also completed within this time. Examinations with a planned time of 60 minutes usually took less time. A comparison between the planned time and the determined examination duration of the most common types of examinations showed overall a slight potential for optimization. Coil exchanges between two examinations had a small, but statistically not significant effect on the median changeover time (p = 0.062). CONCLUSION Utilizing a software-based analysis, a detailed overview of the type of examination, examination duration, and changeover times of frequently used clinical MRI scanners could be obtained. In the clinic examined, there was little potential for optimization of examination planning. An exchange of MRI coils necessary for different types of examination only had a small effect on the changeover times. KEY POINTS · The use of the "Teamplay Usage" software application enables a comprehensive overview of the type of examination, examination duration, and changeover times for MRI scanners.. · Adjustments to examination planning for MRI diagnostics show optimization potential, which, however, is to be assessed as low in the clinic examined.. · Necessary replacements of MRI coils only have a small effect on the changeover times.. CITATION FORMAT · Meyl TP, Berghöfer A, Blatter T et al. Software-Based Evaluation of Optimization Potential for Clinical MRI Scanners in Radiology. Fortschr Röntgenstr 2021; DOI: 10.1055/a-1659-8821.
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Affiliation(s)
- Tobias Philipp Meyl
- Medical Department, Medical Strategy, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Anne Berghöfer
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Germany
| | - Tobias Blatter
- Institute for Clinical Chemnistry, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Johannes T Heverhagen
- Department for Diagnostic, Interventional, and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Maximilian de Bucourt
- Clinic for Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Germany
| | - Martin H Maurer
- Department for Diagnostic, Interventional, and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Analysis of core processes of the MRI workflow for improved capacity utilization. Eur J Radiol 2021; 138:109648. [PMID: 33740625 DOI: 10.1016/j.ejrad.2021.109648] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/14/2021] [Accepted: 03/10/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To analyze core processes of the MRI workflow and to evaluate efficiency for improved patient throughput and capacity utilization. METHOD Prospective data collection was conducted during a four-week time period and a total sum of 160 working hours for each of the two 1.5 T MRI scanners. Three core processes defined the value stream of patient handling before, during and after the MRI examination: i) Scheduling & Registration, ii) Organization & Preparation, and iii) MR scan. Quantitative data was collected for six essential time intervals of the MRI workflow. RESULTS A total of 302 MRI examinations were assessed. The workflow analysis revealed that effective utilization of scan capacity during operating hours varied by scanner (Scanner 1: 77 % / Scanner 2: 85 %). Mean process times for were: patient preparation time 18.9 min (±15.1) p = 0.11, scan preparation time 5.7 min (±4.0) p = 0,015, effective scan time 39.6 min (±18.0) p < 0.0001, scan room occupation time 50.9 min (±21.0) p < 0.0001, clean-up time 5.6 min (±3.2) p = 0.001, total patient handling time 69.7 min (±26.3) p < 0.0001, turnover time 13.4 min (±21.4) p = 0.65. CONCLUSIONS This study demonstrates the utility and applicability of a standardized core processes analyses for MRI scanning, which identified underutilization of scanning capacities, related to multiple factors, such as punctuality of patients, the number of same day cancellations, the process of placing an IV access and patient transport contribute to underutilization of MRI scanners. Furthermore, proactive patient management and effective communication with patients and referring physicians might have relevant time saving potential in the scan room.
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Ahmed ES, Ahmad MN, Othman SH. Business process improvement methods in healthcare: a comparative study. Int J Health Care Qual Assur 2019; 32:887-908. [PMID: 31195926 DOI: 10.1108/ijhcqa-07-2017-0116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE According to the literature concerned with this study, less than satisfactory outcomes have been achieved through implementing business process improvements methods (BPIMs) in industries, in general, and in healthcare, in particular. The existing methods used need to be enhanced in order to create more effective outcomes. There has also been a lack of studies documenting gaps or shortfalls in implementing BPIMs, to be presented to the BPI research community. Therefore, researchers of this paper have attempted to fill gaps between theory and practice. On the contrary, there is also a need to link practical outcomes in the healthcare domain with those of the BPI research community. The purpose of this paper is to review popular BPIMs, techniques and tools applied in the healthcare domain; it seeks to examine and highlight their significant roles, clarify their pros and cons, and find opportunities to enhance their impact on the achievement of more sustainable improvements in the healthcare domain. DESIGN/METHODOLOGY/APPROACH This study has been carried out by using a methodology combining an in-depth literature review with a comparison framework, which is called as the "Framework for Comparing Business Process Improvement Methods." The framework is composed of seven dimensions and has been adapted from four recognized, related frameworks. In addition to the in-depth review of related literature and the adapted comparison framework, researchers have conducted several interviews with healthcare BPI practitioners in different hospitals, to attain their opinions of BPI methods and tools used in their practices. FINDINGS The main results have indicated that significant improvements have been achieved by implementing BPIMs in the healthcare domain according to related literature. However, there were some shortfalls in the existing methods that need to be resolved. The most important of these has been the shortfall in representing and analyzing targeted domain knowledge during improvement phases. The tool currently used for representing the domain, specifically flowcharts, is very abstract and does not present the domain in a clear form. The flowchart tool also fails to clearly present the separation of concerns between business processes and the information systems processes that support a business in a given domain. PRACTICAL IMPLICATIONS The findings of this study can be useful for BPI practitioners and researchers, mainly within the healthcare domain. The findings can help these groups to understand BPIMs shortfalls and encourage them to consider how BPIMs can be potentially improved. ORIGINALITY/VALUE This researchers of this paper have proposed a comparison framework for highlighting popular BPIMs in the healthcare domain, along with their uses and shortfalls. In addition, they have conducted a deep literature review based on the practical results obtained from different healthcare institutions implementing unique BPIMs around the world. There has also been valuable interview feedback attained from BPI leaders of specific hospitals in Saudi Arabia. This combination is expected to contribute to knowledge of BPIMs from both theoretical and practical points of view.
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Affiliation(s)
- Ehab Seed Ahmed
- Department of Information System, Universiti Teknologi Malaysia , Johor, Malaysia.,Department of Health Informatics, Health Information System College, Inaya Medical Colleges , Riyadh, Saudi Arabia
| | - Mohammad Nazir Ahmad
- Institute of Visual Informatics, Universiti Kebangsaan Malaysia , Bangi, Selangor, Malaysia
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A systematic review of Lean in healthcare: a global prospective. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2019. [DOI: 10.1108/ijqrm-12-2018-0346] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Fostered by a rapid spread beyond the manufacturing sector, Lean philosophy for continuous improvement has been widely used in service organizations, primarily in the healthcare sector. However, there is a limited research on the motivating factors, challenges and benefits of implementing Lean in healthcare. Taking this as a valuable opportunity, the purpose of this paper is to present the key motivating factors, limitations or challenges of Lean deployment, benefits of Lean in healthcare and key gaps in the literature as an agenda for future research.
Design/methodology/approach
The authors used the secondary data from the literature (peer-reviewed journal articles) published between 2000 and 2016 to understand the state of the art. The systematic review identified 101 articles across 88 journals recognized by the Association of Business Schools ranking guide 2015.
Findings
The systematic review helped the authors to identify the evolution, current trends, research gaps and an agenda for future research for Lean in healthcare. A bouquet of motivating factors, challenges/limitations and benefits of Lean in healthcare are presented.
Practical implications
The implications of this work include directions for managers and healthcare professionals in healthcare organizations to embark on a focused Lean journey aligned with the strategic objectives. This work could serve as a valuable resource to both practitioners and researchers for learning, investigating and rightly adapting the Lean in the healthcare sector.
Originality/value
This study is perhaps one of the comprehensive systematic literature reviews covering an important agenda of Lean in Healthcare. All the text, figures and tables featured here are original work carried by five authors in collaboration (from three countries, namely, India, the USA and the UK).
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Singer L, Sharee K, Boreta L, Silveira WR, Braunstein S, Fogh S. Quality Improvement Initiative to Improve Tobacco Cessation Efforts in Radiation Oncology. J Oncol Pract 2019; 15:e382-e388. [PMID: 30908138 DOI: 10.1200/jop.18.00593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Although continued tobacco use in patients who are treated with radiation therapy is associated with inferior outcomes and increased treatment-related toxicity, multiple studies have shown that current tobacco cessation efforts in oncology are insufficient. A quality improvement (QI) initiative was developed with the goal of improving tobacco cessation efforts in radiation oncology. METHODS Using iterative plan-do-study-act cycles, barriers to tobacco cessation were identified and then addressed with a single-institutional QI initiative designed to improve physician assessment of patient readiness to quit tobacco by 50% or more. Residents assessed readiness to quit tobacco during new patient consultations and recorded this assessment in prespecified fields within the electronic health record. Feedback on assessment efforts was provided to our department via an automated search of the electronic health record. RESULTS From December 2014 to February 2015, before the initiation of the QI initiative, 4% of patients were assessed for their readiness to quit tobacco. After implementing the initiative, 67% of patients were assessed for their readiness to quit. CONCLUSION After instituting a QI initiative at our institution, significantly more patients were assessed for readiness to quit tobacco before treatment with radiation therapy. Ongoing efforts in our department are aimed at improving the efficacy of this intervention.
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Affiliation(s)
- Lisa Singer
- 1 Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA.,2 Harvard Medical School, Boston, MA
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Classification of Error in Abdominal Imaging: Pearls and Pitfalls for Radiologists. Can Assoc Radiol J 2018; 69:409-416. [PMID: 30318459 DOI: 10.1016/j.carj.2018.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/18/2018] [Indexed: 11/22/2022] Open
Abstract
Peer review for radiologists plays an important role in identifying contributing factors that can lead to diagnostic errors and patient harm. It is essential that all radiologists be aware of the multifactorial causes of diagnostic error in radiology and the methods available to reduce it. This pictorial review provides readers with an overview of common errors that occur in abdominal radiology and strategies to reduce them. This review aims to make readers more aware of pitfalls in abdominal imaging so that these errors can be avoided in the future. This essay also provides a systematic approach to classifying abdominal imaging errors that will be of value to all radiologists participating in peer review.
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Itri JN, Bakow E, Probyn L, Kadom N, Duong PAT, Gettle LM, Mendiratta-Lala M, Scali EP, Winokur RS, Zygmont ME, Kung JW, Rosenkrantz AB. The Science of Quality Improvement. Acad Radiol 2017; 24:253-262. [PMID: 28193375 DOI: 10.1016/j.acra.2016.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/04/2016] [Accepted: 05/05/2016] [Indexed: 02/04/2023]
Abstract
Scientific rigor should be consistently applied to quality improvement (QI) research to ensure that healthcare interventions improve quality and patient safety before widespread implementation. This article provides an overview of the various study designs that can be used for QI research depending on the stage of investigation, scope of the QI intervention, constraints on the researchers and intervention being studied, and evidence needed to support widespread implementation. The most commonly used designs in QI studies are quasi-experimental designs. Randomized controlled trials and cluster randomized trials are typically reserved for large-scale research projects evaluating the effectiveness of QI interventions that may be implemented broadly, have more than a minimal impact on patients, or are costly. Systematic reviews of QI studies will play an important role in providing overviews of evidence supporting particular QI interventions or methods of achieving change. We also review the general requirements for developing quality measures for reimbursement, public reporting, and pay-for-performance initiatives. A critical part of the testing process for quality measures includes assessment of feasibility, reliability, validity, and unintended consequences. Finally, publication and critical appraisal of QI work is discussed as an essential component to generating evidence supporting QI initiatives in radiology.
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Affiliation(s)
- Jason N Itri
- Department of Radiology, University of Virginia, 1215 Lee Street, Box 800170, Charlottesville, CA 22908.
| | - Eric Bakow
- UPMC Health Plan, Pittsburgh, Pennsylvania
| | - Linda Probyn
- Sunnybrook Health Sciences Centre, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | | | - Lori Mankowski Gettle
- Division of Abdominal Imaging and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Mishal Mendiratta-Lala
- Abdominal and Cross-sectional Interventional Radiology, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Elena P Scali
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ronald S Winokur
- Department of Radiology, Division of Interventional Radiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York
| | - Matthew E Zygmont
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Justin W Kung
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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