Safety and Quality in Radiology
In 3rd annual conference, American College of Radiology focused on safety, utilization, process improvement, and physician outcomes.
The American College of Radiology (ACR) held its third annual conference on quality and safety in radiology — Maximizing Value in Radiology Through Quality and Safety Improvements — Oct 22 and 23 in Phoenix, Arizona. The conference was organized by the ACR and drew heavily from expertise at Mayo Clinic (Rochester, Minn., and Scottsdale, Ariz.) and Virginia Mason Medical Center in Seattle. Daniel Johnson, MD, FACR, chair of radiology at Mayo Clinic Arizona, was program chair.
The program covered central principles of patient safety and quality improvement in the context of radiology and reported in depth on radiology-specific problems and solutions.
Though the format was not the most important factor in the conference’s impact, it certainly added value to the program. Presentations were either 10 or 20 minutes long, and it’s easy to imagine that having limited time encouraged speakers to be succinct and focused. To quote Toby Gilk, an MRI safety expert who attended and spoke at the conference: “All wheat; no chaf.”
The two-day program was organized into an overview plus four sessions focused on safety, utilization, process improvement, and physician outcomes. In addition, 16 proffered papers were presented in 10-minute overviews. These summaries provided enticing “tip of the iceberg” glimpses into meaningful, applicable research. Click here to see the program.
Another aspect of the program was Q&A discussions, which I enjoyed for their content as well as format. At the conclusion of each topical session, the speakers—usually three or four—took questions as a panel, which worked well for framing questions around broad issues and fostering conversation among the speakers. Questions from the audience provided another sub-plot. Many questions were along the lines of, “Thank you for your presentation. I’m in private practice (or in one case, managing a collection of small practices, ‘Onesies and twosies’) and trying to figure out how I can apply these principles to my practice with very limited resources.” I see private practices joining the patient safety conversation in increasing numbers. I hope that all organizations that sponsor conferences about safety and quality, including ACR, will begin to include strategies for smaller practices with limited budgets.
What follows is the first in a series of blog postings about the conference, meant more as appetizers and food for thought than as a full representation of this content-rich, 2-day conference.
Following a brief introduction by Dr. Johnson, Steve Swensen, MD, FACR, director for quality and professor of radiology at Mayo Clinic Rochester, gave the first presentation of the conference, “The 5 Wishes of a Radiology Patient: Our Imperative for Change.” This presentation was based on a paper Swensen co-authored with Johnson (2010), in which they make a case for patient-centered radiology and identify the following five wishes of radiology patients:
- The information necessary to make the right health care decision
- The right examination
- A safe examination
- Effective communication of correctly interpreted results
- A fair price
With this framework, Swensen established broad principles of healthcare quality as the agenda for the conference. He went on to apply these principles to specifics areas where radiology can become involved in improvement efforts, including over-utilization, critical results reporting, patient identification, hand hygiene, falls, and medication errors. The list of problems covered pretty much all areas targeted in patient safety and quality improvement efforts throughout medicine.
To reinforce his point about patient-centeredness, Swensen cited a study presented at RSNA 2008, which clearly struck a cord with the audience in Phoenix, as it was mentioned a number of times by other speakers and in questions throughout conference. The study, “The Effects of Including a Patient’s Photograph to the Radiographic Examination,” was done by Yehonaton Turner, MD, a radiology resident at Shaare Zedek Medical Center in Jerusalem. Turner found that having a picture of the patient’s face automatically appear with the CT study improved the quality of the interpretation as shown in length of the report, number of incidental findings, and recommendations for care management (RSNA, 2009). In his presentation at RSNA, Turner said, “The addition of a photograph enables a more personal approach to the interpretation, especially when the radiologist is not in physical contact with the patient. It is important for radiologists to be aware that radiographs represent a patient, not merely just another case.” Citing this study was an effective way to launch two days of serious discussion about issues crucial to the future direction of radiology and healthcare in general.
References
RSNA. (2009, March). Photos increase radiologist-patient connection. RSNA News. Available at http://www.rsna.org/Publications/rsnanews/March-2009/Photos_feature.cfm
Swensen, S. J. & Johnson, C. D. (2010). Flying in the plane you service: Patient-centered radiology. Journal of the American College of Radiology, 7, 216–221.