American Board of Radiology Perspective on Maintenance of Certification: Part IV—Practice Quality Improvement for Diagnostic Radiology

A workstation-integrated peer review quality assurance program: pilot study

“…In part, the higher disagreements in research studies may also arise from the very nature of the research protocols, where a wider range of findings are systematically evaluated and recorded in contrast to a lesser range in a typical clinical report. There is currently no objective benchmark for an acceptable level of disagreement in clinical practice [5,7,8,14], Given the fact that a number of unexplained variables have been identified to be associated with rates of disagreement, as noted above, there is reluctance to even attempt to define appropriate rates until further information is available [4,13,19,22]. One suggestion to improve the utility of the RADPEER system has been to allow comments in score 1 cases.…”

“…This methodology is not applicable to most areas in diagnostic radiology. The surrogate indicator of radiological excellence that has become accepted is consistency of assessments between radiologists, and the technique that has become the standard for evaluating concordance is peer review [1-4,7,8,13]. The underlying intent is that the results of such reviews should act as an impetus for self-learning and other educational activities that ultimately lead to improved radiological performance and better patient outcomes [2,4,7,9,13-16].…”

“…One example is 360-degree feedback where radiologists have questionnaires completed by fellow radiologists, referring physicians, other healthcare staff, and patients, assessing a variety of topics including the quality of radiological assessments [6]. A second type of peer review is double reading, in which a random selection of routine cases is chosen for a second read, with any discrepancies between reads adjudicated by a third radiologist [5,7,11]. By far the most-used peer review approach in North America is the RADPEER program of the American College of Radiology (ACR) [3,4].…”

Credentialing for radiology

“…There is an expectation that patients will receive safe, predictable and high-quality care delivered by competent professionals [3]. Due to the rapid development and expansion of diagnostic and interventional radiology over the past 20 years, it has become important to provide specific training in existing and new modalities.…”

“…While professional organisations provide opportunities for continuing education, they do not provide credentialling; places of work must do this. Clearly the ultimate goal is to achieve ongoing improvement of practice and to demonstrate competency as a medical practitioner [3]. …”