Creating a Radiology Quality and Safety Program: Principles and Pitfalls

Broder, Jennifer C.; Cameron, Scott F; Korn, William T; Baccei, Steven J.

doi:10.1148/rg.2018180032

Cited by 21 publications

(12 citation statements)

References 43 publications

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“…Table 1 proposes a tool that imaging teams could use to reflect on PCC in their practice and on ways to improve it. This tool, based on the six elements of PCC, could be a useful complement to other quality improvement tools and initiatives [ 28 , 41 , 43 , 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

Creating person-al space for unspoken voices during diagnostic medical imaging examinations: a qualitative study

Makanjee

Bergh

et al. 2021

BMC Health Serv Res

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Background There is emerging interest in person-centred care within a short-lived yet complex medical imaging encounter. This study explored this event from the viewpoint of patients referred for an imaging examination, with a focus on the person and their person-al space. Methods We used convenience sampling to conduct semi-structured interviews with 21 patients in a private medical imaging practice in Australia. The first phase of data analysis was conducted deductively, using the six elements of the person-centred, patient-journey framework of the Australian Commission on Safety and Quality in Healthcare: transition in; engagement; decisions; well-being; experience; and transition out. This was followed by inductive content analysis to identify overarching themes that span a patient’s journey into, through and out of an imaging encounter. Results The transition-in phase began with an appointment and the first point of contact with the imaging department at reception. Engagement focused on patient-radiographer interactions and explanations to the patient on what was going to happen. Decisions related primarily to radiographers’ decisions on how to conduct a particular examination and how to get patient cooperation. Participants’ well-being related to their appreciation of gentle treatment; they also referred to past negative experiences that had made a lasting impression. Transitioning out of the imaging encounter included the sending of the results to the referring medical practitioner. Person-al vulnerabilities emerged as a cross-cutting theme. Patients’ vulnerability, for which they needed reassurance, pertained to uncertainties about the investigation and the possible results. Healthcare professionals were vulnerable because of patient expectations of a certain demeanour and of pressure to perform optimal quality investigations. Lastly, patients’ personal lives, concerns and pressures – their person-al ‘baggage’ – shaped their experience of the imaging encounter. Conclusion To add value to the quality of the service they deliver, radiography practitioners should endeavour to create a person-al space for clients. Creating these spaces is complex as patients are not in a position to judge the procedures required by technical imaging protocols and the quality control of equipment. A reflective tool is proposed for radiographers to use in discussions with their team and its leaders on improving person-centred care and the quality of services in their practice.

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Section: Discussionmentioning

confidence: 99%

Creating person-al space for unspoken voices during diagnostic medical imaging examinations: a qualitative study

Makanjee

Bergh

et al. 2021

BMC Health Serv Res

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“…[ 17 ] Time has been identified by many as a critical component of successful PQI projects. [ 3 , 17 , 30 , 32 , 33 , 34 ] Broder et al. [ 3 ] advocated in their article that extra staffing is a prerequisite for successful QI projects.…”

Section: Medical Physicists’ Pqimentioning

confidence: 99%

The need for dedicated time for medical physicists practice quality improvement efforts in radiation oncology department: A commentary

Zellars

Njeh

Marquette

2022

J Applied Clin Med Phys

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There is no universally accepted definition of quality improvement (QI). However, the American Board of Radiology (ABR) defines "QI"as "a systematic approach to the study of healthcare and/or a commitment to efforts to continuously improve performance and outcomes in healthcare". According to Kruskal et al., [1] QI in radiation oncology includes "(a) quality assurance programs for continuous improvements in quality, (b) processes to improve staff and patient safety, and (c) procedures to improve the clinical,technical,and therapy performance of all staff ". [1] Fundamentally, QI techniques are, well founded methods to drive change and improve efficiency. The goal of QI is therefore to create practical processes and structures that will introduce positive change into a work environment in a reproducible and sustainable way that is non-disruptive and at an acceptable cost. There are many forces that can drive the creation of QI programs in radiation oncology. The first is the desire to provide high-quality patient care, which is defined by the Institute of Medicine as "safe, effective, patient-centered, timely, efficient, and equitable care". [2] The second is the mandate of accrediting bodies such as the Joint Commission and the American College of Radiology (ACR), whose accrediting standards further support this goal. The third is the economic incentives to provide high-quality care at an affordable cost. [3] Clinical medical physicists (MPs) are often viewed as the custodians of quality in radiation therapy department. Radiation therapy is a long-complicated process and therefore has numerous avenues for potential QI endeavors. [4,5] These QI initiatives demand time and resources to be successful. More often, when time is not reserved, these initiatives become administrative burdens on the staff adding to their already established workflow. To make QI relevant, feasible and sustainable, it is necessary to embed it into MP workflow. This act transforms QI from a burden, which places anThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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“…24 A just culture holds individuals accountable to organizational standards, but accepts that even the most competent professionals make errors, and that imperfect organizational systems create error-prone conditions. 25 A just culture requires understanding and support from institutional leaders, coinciding with alignment of institutional goals and policies with the improved culture. Consistent application of the just culture to quality improvement processes necessitates ongoing leadership and community engagement in the process.…”

Section: Overarching Goalsmentioning

confidence: 99%

CAR Peer Learning Guide

et al. 2022

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Peer learning is a quality initiative used to identify potential areas of practice improvement, both on a patient level and on a systemic level. Opportunities for peer learning include review of prior imaging studies, evaluation of cases from multidisciplinary case conferences, and review of radiology trainees’ call cases. Peer learning is non-punitive and focuses on promoting life-long learning. It seeks to identify and disseminate learning opportunities and areas for systems improvement compared to traditional peer review. Learning opportunities arise from peer learning through both individual communication of cases reviewed for routine work, as well as through anonymous presentation of aggregate cases in an educational format. In conjunction with other tools such as root cause analysis, peer learning can be used to guide future practice improvement opportunities. This guide provides definitions of terms and a synthetic evidence review regarding peer review and peer learning, as well as medicolegal and jurisdictional considerations. Important aspects of what makes an effective peer learning program and best practices for implementing such a program are presented. The guide is intended to be a living document that will be updated regularly as new data emerges and peer learning continues to evolve in radiology practices.

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Creating a Radiology Quality and Safety Program: Principles and Pitfalls

Cited by 21 publications

References 43 publications

Creating person-al space for unspoken voices during diagnostic medical imaging examinations: a qualitative study

Creating person-al space for unspoken voices during diagnostic medical imaging examinations: a qualitative study

The need for dedicated time for medical physicists practice quality improvement efforts in radiation oncology department: A commentary

CAR Peer Learning Guide

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